Rare but severe bacterial infection of the heart valves; see main IE notes

Aetiology

• Gram-positive bacteria represent the majority of organisms responsible for pediatric IE - includes viridans group streptococci, staphylococci and enteroccoci
• Can also be caused by gram-negatives and fungi

Clinical features

• Most cases of pediatric endocarditis present subacutely - low-grade fever, malaise, myalgias, arthralgias, and headaches
• New or changing heart murmur may be auscultated

Management

• Obtain culture, then start empirical antibiotics, transition to specific antibiotics based on culture results