Modern Pediatrics. Ukraine. (2026).2(154): 117-121. doi: 10.15574/SP.2026.2(154).117121
Selska Z. V.
Bogomolets National Medical University, Kyiv, Ukraine

For citation: Selska ZV. (2026). Clinical case of infective endocarditis in a teenager with operated tetralogy of Fallot. Modern Pediatrics. Ukraine. 2(154): 117-121. doi: 10.15574/SP.2026.2(154).117121.
Article received: Nov 17, 2025. Accepted for publication: Mar 16, 2026.

Children with operated heart defects have a high risk of developing infective endocarditis. This is due to the fact that they have suffered endocardial trauma during surgical interventions and present with residual hemodynamic changes in the heart. In clinical practice, it is often difficult to recognize infective endocarditis in a patient, make a timely diagnosis, and initiate correct treatment.
Aim – to analyze a case of infective endocarditis in a teenager with corrected tetralogy of Fallot to raise awareness among physicians regarding the diagnosis and treatment of this disease.
Clinical case. A 17-year-old boy was admitted to the Clinical Children's Hospital of Kyiv with complaints of: fever up to 38.5°C, cough, runny nose, weakness, lethargy, significant loss of appetite, weight loss of 7-8 kg, abdominal pain, pain in the right side of the chest. The child had been ill for 5 weeks, prior treatment included oral nonsteroidal anti-inflammatory drugs and oral antibiotics, which provided no relief. The patient's medical history revealed three surgical interventions for tetralogy of Fallot are known. After a three-day stay in the hospital, the patient's condition worsened. Following consultation with a cardiologist, the patient was referred to the Center for Pediatric Cardiology and Cardiac Surgery, where the diagnosis of infective endocarditis was confirmed and the patient was transferred to the latter institution for further treatment.
Conclusions. Children with operated heart defects should be considered a risk group for developing infective endocarditis.  At the slightest suspicion of the presence of this disease, the patient should be immediately referred for a consultation with a cardiologist or to centers for pediatric cardiology and cardiac surgery, which will improve the diagnosis, treatment, and prognosis of the disease.
The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from the child and the child's parents to participate in the study.
The author declares no conflict of interest.
Keywords: children, congenital heart disease, infective endocarditis, diagnostics.

REFERENCES

1. Abramczyk U, Czesniewich P, Kusa J. (2024). Infective endocarditis in children as an increasing clinical problem – a case series. Children (Basel). 11(3): 371. https://doi.org/10.3390/children11030371; PMid:38539406 PMCid:PMC10969324

2. Dardari M, Cintesa E, Vasile CM, Padovani P, Vatasescu R. (2023). Infective endocarditis among pediatric patients with prosthetic valves and cardiac devices: A review and update of recent emerging diagnostic and management strategies. Journal of Clinical Medicine. 12(15): 4941. https://doi.org/10.3390/jcm12154941; PMid:37568344 PMCid:PMC10420327

3. Delgado V, Marsan NA, Waha S et al. (2023). 2023 ESC Guidelines for the management of endocarditis. European Heart Journal. 44(39): 3948-4042. https://doi.org/10.1093/eurheartj/ehad193; PMid:37622656

4. Ferro D, Urrutia J, Cortes MC, Rodrigues S, Jaramillo A. (2022). Difficult diagnosis infective endocarditis in a pediatric patient: case report. Cardiovascular and Metabolic science. 33(2): 73-77. https://doi.org/10.35366/105822

5. Marin-Cruz I, Pedrero-Tome R, Toran B et al. (2024). Infective endocarditis in pediatric patients: a decade of insights from a leading Spanish heart surgery reference center. European Journal of Pediatrics. 183: 3905-3913. https://doi.org/10.1007/s00431-024-05606-3; PMid:38913227 PMCid:PMC11322191

6. Moing V, Bonnet E, Cattoir V et al. (2025). Antibiotic therapy and prophylaxis of ifective endocarditis – A SPILF-AEPEI position statement on the ESC 2023 guidelines. Infectious Diseases Now. 55(1): 105011. https://doi.org/10.1016/j.idnow.2024.105011; PMid:39561877

7. Remyon P, Tromeur T, Gras P et al. (2025). Oral antibiotic step-down therapy for pediatric infective endocarditis: a single-center retrospective experience. Archives of Cardiovascular Diseases. 118(8-9): S259. https://doi.org/10.1016/j.acvd.2025.06.022

8. Vicent L, Luna R, Martinez-Selles M. (2022). Pediatric infective endocarditis: a literature review. Journal of Clinical Medicine. 11(11): 3217. https://doi.org/10.3390/jcm11113217; PMid:35683606 PMCid:PMC9181776