Emergency physician diagnosis of pediatric infective endocarditis by point-of-care echocardiography

Infective endocarditis is an uncommon infection in children and may rarely present to the emergency department. The clinical diagnosis of infective endocarditis in children can be challenging, especially in children without a history of underlying cardiac disease. Misdiagnosis or delayed diagnosis may lead to substantial morbidity and mortality. The modified Duke criteria for diagnosing infective endocarditis include echocardiographic findings as major criteria, vegetations on valves or supporting structures, periannular abscess, or new valvular regurgitation. Use of focused point-of-care echocardiography is growing in acute care settings such as emergency departments and can assist in the immediate diagnosis of endocarditis. Focused point-of-care echocardiography is noninvasive, is painless, and can be performed at bedside. Diagnosing infective endocarditis in a pediatric patient by focused point-of-care echocardiography has not been previously reported. We report a case of infective endocarditis in a 16-year-old girl diagnosed by focused point-of-care echocardiography in the emergency department.