The most common pathogens are bacterial, although they may also be fungal. Any child with a heart condition can get endocarditis but it can occasionally affect normal valves.

Clinical features

  • Fever
  • Splenomegaly
  • Petechiae
  • new murmurs.


  • Full blood count
  • Urinalysis
  • Blood culture
  • Electrocardiogram
  • Echocardiography


  • Give penicillin 100,000–400,000U/kg/24 hour IV 4–6 hourly, and gentamicin 6–7.5mg/kg/24 hours.
  • Monitor carefully for response.
  • If patient is not improving, consider changing antibiotic after results of culture.
  • Refer to specialist if:
    • No or poor response to therapy.
    • Patient deteriorates.