Subacute bacterial endocarditis

Question 1

Risk factors of SBE

Answer 1

• and child with CHD - execpt secundum ASD
  
  • higher risk with VSD, coarctation of aorta, PDA
• Prosthetic material insertion at surgery

Question 2

Causes of SBE

Answer 2

• most common: streptococcus viridans (group alpha-haemolytic)

Question 3

Presentation of SBE

Answer 3

• Fever (sustained)
• anaemia/ pallor
• splinter haemorrhages
• clubbing (late sign)
• necrotic skin lesions
• changing cardiac signs
• spleomegaly
• neurological signs from cerebral infarction
• retinal infarcts
• arthritis/ arthralgia
• haematuria

Question 4

Treatment of SBE

Answer 4

• high dose penicillin
  
  • • aminoglycoside
  • 6 week IV
  • continuously checking serum level of antibiotic
• surgical removal of prosthetic device/ vegetations required if due to infected prosthetic material