Infective Endocarditis in Children: Acute vs Subacute Types and Their Differences

Acute infective endocarditis is a relatively rare condition in children, typically occurring in those with previously healthy hearts. This form of endocarditis is most commonly caused by Staphylococcus aureus, a bacterium known for its aggressive nature. The clinical presentation of acute endocarditis tends to be sudden and severe, with symptoms developing rapidly over a short period.

Clinical Features of Acute Infective Endocarditis

Children affected by the acute form often experience high fever, chills, and a general feeling of being unwell. The disease progresses quickly and can lead to serious complications such as acute congestive heart failure. Without prompt medical attention, the infection can become life-threatening and may even result in death. Early diagnosis and treatment are crucial in managing this condition effectively.

Subacute Bacterial Endocarditis: A Different Presentation

On the other hand, subacute bacterial endocarditis is more commonly seen in pediatric patients with pre-existing congenital heart defects. This type is predominantly caused by Streptococcus viridans, a less aggressive bacterial strain compared to Staphylococcus aureus. The onset of symptoms in subacute cases is usually gradual, often developing over weeks or even months.

Common Symptoms of Subacute Endocarditis

Patients may experience non-specific symptoms such as fatigue, weight loss, and mild to moderate fever. Other signs include pallor due to anemia, general malaise, and enlargement of the liver and spleen. These subtle symptoms can make diagnosis challenging, as they often mimic other less severe illnesses.

Key Differences Between Acute and Subacute Forms

While both acute and subacute endocarditis affect the inner lining of the heart, they differ significantly in terms of causative agents, disease progression, and clinical manifestations. Acute cases tend to affect otherwise healthy children and progress rapidly, whereas subacute cases typically occur in those with underlying heart conditions and develop more slowly.

Understanding these distinctions is essential for healthcare professionals to provide timely and appropriate treatment. Proper identification of the type of endocarditis helps guide antibiotic selection, determine the need for surgical intervention, and improve patient outcomes.