Inflammation of heart's inner tissues.Encyclopedia Entry for Endocarditis :Endocarditis - children. Endocarditis occurs when germs enter the bloodstream and then travel to the heart. Bacterial infection is the most common cause Fungal infections are much more rare In some cases, no germs can be found after testing Endocarditis can involve the heart muscle, heart valves, or lining of the heart. Children with endocarditis may have a: Birth defect of the heart Damaged or abnormal heart valve New heart valve after surgery The risk is higher in children who have a history of heart surgery, which can leave rough areas in the lining of the heart chambers. This makes it easier for bacteria to stick to the lining. Germs are most likely to enter the bloodstream: By way of a central venous access line that is in place During dental surgery During other surgeries or minor procedures to the airways and lungs, urinary tract, infected skin, or bones and muscles.Symptoms of endocarditis may develop slowly or suddenly. Fever, chills, and sweating are frequent symptoms. These sometimes can: Be present for days before any other symptoms appear Come and go, or be more noticeable at nighttime Other symptoms may include: Tiredness Weakness Joint pain Muscle pain Trouble breathing Weight loss Neurological problems, such as seizures and, disturbed mental status Signs of endocarditis can also include: Small bleeding areas under the nails ( splinter hemorrhages ) Red, painless skin spots on the palms and soles (Janeway lesions) Red, painful nodes in the pads of the fingers and toes (Osler nodes) Shortness of breath Swelling of feet, legs, abdomen.Your child's health care provider may perform transthoracic echocardiography (TTE) to check for endocarditis in children age 10 years or younger. Other tests may include: Blood culture to help identify the bacteria or fungus that is causing the infection Complete blood count (CBC) C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR).Treatment for endocarditis depends upon the: Cause of the infection Child's age Severity of the symptoms Your child will need to be in the hospital to receive antibiotics through a vein (IV). Blood cultures and tests will help the provider choose the best antibiotic. Your child will need long-term antibiotic therapy. Your child will need this therapy for 4 to 8 weeks to fully kill all the bacteria from the heart chambers and valves. Antibiotic treatments started in the hospital will need to be continued at home once your child is stable. Surgery to replace an infected heart valve may be needed when: Antibiotics don't work to treat the infection The infection is breaking off in little pieces, resulting in strokes The child develops heart failure as a result of damaged heart valves The heart valve is badly damaged.Getting treatment for endocarditis right away improves the chances of clearing the infection and preventing complications.The possible complications of endocarditis in children are: Damage to the heart and heart valves Abscess in the heart muscle Infective clot in the coronary arteries Stroke, caused by small clots or pieces of the infection breaking off and traveling to the brain Spread of the infection to other parts of the body, such as the lungs.Call your child's provider if you notice the following symptoms during or after treatment: Blood in urine Chest pain Fatigue Fever Numbness Weakness Weight loss without a change in diet.The American Heart Association recommends preventive antibiotics for children at risk for endocarditis, such as those with: Certain birth defects of the heart Heart transplant and valve problems Man-made (prosthetic) heart valves A past history of endocarditis These children should receive antibiotics when they have: Dental procedures that are likely to cause bleeding Procedures involving the breathing tract, the urinary tract, or the digestive tract Procedures on skin infections and soft tissue infections.Valve infection - children; Staphylococcus aureus - endocarditis - children; Enterococcus - endocarditis- children; Streptococcus viridians - endocarditis - children; Candida - endocarditis - children; Bacterial endocarditis - children; Infective endocarditis - children; Congenital heart disease - endocarditis - children.Baltimore RS, Gewitz M, Baddour LM, et al; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young and the Council on Cardiovascular and Stroke Nursing. Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart Association. Circulation. 2015;132(15):1487-1515. PMID: 26373317 www.ncbi.nlm.nih.gov/pubmed/26373317. Marcdante KJ, Kliegman RM. Infective endocarditis.Encyclopedia Entry for Endocarditis :Endocarditis. Endocarditis can involve the heart muscle, heart valves, or lining of the heart. Some people who develop endocarditis have a: Birth defect of the heart Damaged or abnormal heart valve History of endocarditis New heart valve after surgery Parenteral (intravenous) drug addiction Endocarditis begins when germs enter the bloodstream and then travel to the heart. Bacterial infection is the most common cause of endocarditis. Endocarditis can also be caused by fungi, such as Candida. In some cases, no cause can be found. Germs are most likely to enter the bloodstream during: Central venous access lines Injection drug use, from the use of unclean (unsterile) needles Recent dental surgery Other surgeries or minor procedures to the breathing tract, urinary tract, infected skin, or bones and muscles.Symptoms of endocarditis may develop slowly or suddenly. Fever, chills, and sweating are frequent symptoms. These sometimes can: Be present for days before any other symptoms appear Come and go, or be more noticeable at nighttime You may also have fatigue, weakness, and aches and pains in the muscles or joints. Other signs can include: Small areas of bleeding under the nails ( splinter hemorrhages ) Red, painless skin spots on the palms and soles (Janeway lesions) Red, painful nodes in the pads of the fingers and toes (Osler nodes) Shortness of breath with activity Swelling of feet, legs, abdomen.The health care provider may detect a new heart murmur , or a change in a past heart murmur. An eye exam may show bleeding in the retina and a central area of clearing. This finding is known as Roth spots. There may be small, pinpoint areas of bleeding on the surface of the eye or the eyelids. Tests that may be done include: Blood culture to help identify the bacteria or fungus that is causing the infection Complete blood count (CBC), C-reactive protein (CRP), or erythrocyte sedimentation rate (ESR) An echocardiogram to look at the heart valves.You may need to be in hospital to get antibiotics through a vein (IV or intravenously). Blood cultures and tests will help your provider choose the best antibiotic. You will then need long-term antibiotic therapy. People most often need therapy for 4 to 6 weeks to fully kill all the bacteria from the heart chambers and valves. Antibiotic treatments that are started in the hospital will need to be continued at home. Surgery to replace the heart valve is often needed when: The infection is breaking off in little pieces, resulting in strokes. The person develops heart failure as a result of damaged heart valves. There is evidence of more severe organ damage.Getting treatment for endocarditis right away improves the chances of a good outcome. More serious problems that may develop include: Brain abscess Further damage to the heart valves, causing heart failure Spread of the infection to other parts of the body Stroke, caused by small clots or pieces of the infection breaking off and traveling to the brain.Call your provider if you notice the following symptoms during or after treatment: Blood in urine Chest pain Fatigue Fever that doesn't go away in two or three days Fever Numbness Weakness Weight loss without change in diet.The American Heart Association recommends preventive antibiotics for people at risk for infectious endocarditis, such as those with: Certain birth defects of the heart Heart transplant and valve problems Man-made (prosthetic) heart valves Past history of endocarditis These people should receive antibiotics when they have: Dental procedures that are likely to cause bleeding Procedures involving the breathing tract Procedures involving the urinary tract system Procedures involving the digestive tract Procedures on skin infections and soft tissue infections.Valve infection; Staphylococcus aureus - endocarditis; Enterococcus - endocarditis; Streptococcus viridans - endocarditis; Candida - endocarditis.Heart valve surgery - discharge.Heart, section through the middle Heart, section through the middle Heart, front view Heart, front view Janeway lesion - close-up Janeway lesion - close-up Janeway lesion on the finger Janeway lesion on the finger Heart valves Heart valves.Baddour LM, Freeman WK, Suri RM, Wilson WR. Cardiovascular infections.