Endocarditis in Patients with Congenital Heart Disease

Endocarditis in patients with congenital heart disease often can be traced to intermittent bacteremia due to dental caries, chronic infection, and intraoperative contamination. Infective endocarditis is the infection of the endothelial lining of the heart. Surgical and catheter-based interventional advances in the treatment of congenital heart disease have increased the risk for infective endocarditis. Prolonged antibiotic therapy may not eradicate the infection because the biofilm acts as a protective slime layer. The array of organisms identified as causative agents in infective endocarditis continues to grow, especially with the availability of molecular diagnostic techniques. Combined information from clinical, laboratory, and imaging areas assists in the diagnosis of infective endocarditis. Treatment of infective endocarditis depends on prolonged antimicrobial therapy with or without surgical intervention. Timing of surgery in infective endocarditis should not be based on duration of preoperative antibiotics alone, but rather on the clinical status of the patient.