INFECTIVE ENDOCARDITIS PREVENTION: Advice for children and adults
with heart abnormalities.
This
page is also available as a PDF.
Based on a document from the Children's Heart Service at the John
Radcliffe Hospital . Oxford.
What is infective endocarditis?
It is an illness in which infection settles inside the heart or
great blood vessels. It is most usually caused by bacteria, but
fungi and other infective agents can more rarely be the cause.
It can occur in people with normal hearts but is much more likely
to occur in those with an abnormality of the heart. It is however
even so a rare disease.
How does the infection get to the heart?
Infection gets to the heart when bacteria are carried there in
the blood stream. Large numbers of bacteria may get into the blood
stream in various ways. These include:
- at dental extraction and some other operations
- from infected eczema
- from cuts, grazes, blisters or chicken pox spots that have
become septic instead of healing up nicely
- from inflammation and infection around earrings
Ordinary cuts and grazes which heal quickly and cleanly are not
a risk, nor is biting ones tongue or lip. Natural loss of milk
teeth does not scatter bacteria into the blood and some superficial
dental work is no cause for concern. Your dentist will know what
procedures matter for your child. Infective carditis is not passed
between people.
How can infective endocarditis be prevented?
There are several easy ways to reduce the risk of infective carditis:
- Keep teeth healthy by sensible eating habits and twice daily
brushing
- Have regular 6 monthly check-ups by the dentist so that any
dental treatment will probably be minor rather than extractions.
- If a dentist removes a tooth or does some deep work on the
teeth or gums give antibiotics about one hour beforehand and
usually 4-6 hours afterwards. This kills the bacteria round
the tooth at just the time they would otherwise be scattered
into the blood. Your dentist will know details of what needs
to be done.
- Some non dental operations can cause bacteria to be scattered
into the blood and require antibiotics to be given.
- Always tell doctors and dentists that your child has a heart
abnormality so that they can decide if antibiotics are needed
for what they are dealing with. If they are unsure they can
contact the Children's Heart Service which is looking after
your child.
Does this advice apply to all children and adults with heart
abnormalities?
It applies to nearly all, whether or not they have had or will
even need surgery. If you are unsure whether it applies to your
child please ask the heart doctors looking after you.
The main groups it does not apply to are;
- those with simple atrial septal defects unless they have had
it repaired in the previous 3 months.
- those who have had a patent ductus arteriosus closed spontaneously
or by surgery more than three months ago.
- many of those who have had a ventricular defect which has
closed by itself.
This
page is also available as a PDF.
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