Pediatric Infective Endocarditis

  • Etiology: Infection of endocardium which commonly affects vegetations on valve leaflets and prosthetic valves
  • Imaging CXR:
    — Valve leaflet destruction results in signs of congestive heart failure
    — Embolization of vegetation fragments result in septic pulmonary emboli
  • DDX of vegetations: Myxomas, thrombi
  • Complications:
    — Septic emboli to brain, lungs (especially in right-sided infective endcarditis), spleen, kidneys, liver, muscles, bones
    — Mycotic aneurysms
    — Aortic root abscess
  • Treatment: Antibiotics and surgery
  • Clinical:

Radiology Cases of Infective Endocarditis

Radiology Cases of Infective Endocarditis Leading to Mitral Insufficiency Resulting in Cardiac Failure

CXR of pulmonary edema due to mitral insufficiency in rheumatic heart disease
CXR AP shows cardiomegaly and bilateral perihilar interstitial infiltrates.

Radiology Cases of Infective Endocarditis Leading to Septic Pulmonary Emboli

CXR and CT of septic emboli in the lungs / septic pulmonary emboli
CXR AP (above) shows prominence of the central pulmonary arteries and multiple round lesions of varying size throughout both lungs which on the axial CT with contrast of the chest (below) are shown to have indistinct margins.

Radiology Cases of Infective Endocarditis Leading to Cerebral Abscess and Splenic Abscess and Renal Abscess

MRI of infective endocarditis of the brain and CT of infective endocarditis of the spleen and kidneys
Coronal T1 MRI with contrast of the brain (above) shows multiple small enhancing lesions in the brain and one large ring enhancing lesion in the right hemisphere of the brain. Coronal CT with contrast of the abdomen (below) shows multiple peripheral low density wedge shaped lesions in the spleen and both kidneys.