Endocarditis


Endocarditis is the bacterial infection of the endocardium or the thin membrane that lines the chambers of the heart and the heart valves.

Subacute endocarditis
Subacute endocarditis affecting the mitral valve: destruction of the
mitral valve fibrin due to Haemophilus parainfluenzae bacterial infection.

Who Gets It?

People who are particularly susceptible to endocarditis infection are those with pre-existing heart conditions and abnormalities, such as:

  • Congenital abnormal heart valves (such as mitral valve prolapse)
  • Septal defect (a small hole in the walls of the heart chambers)
  • Artificial heart valves
  • Coarctation of the aorta (narrowing of the aorta that causes increased blood pressure)

Infection of the heart tissue occurs when bacteria is introduced into the blood stream during:

  • Dental cleanings or procedures
  • Surgeries of the upper respiratory tract, colon, and urinary tract
  • Gynecological procedures
  • Improper cleaning of injection site or using dirty needles for intravenous or IV drug users

Because of this susceptibility to endocarditis, people with pre-existing heart conditions should notify their doctor and dentists before any medical procedures. Routine antibiotics such as erythromycin and penicillin given the day before, the day of, and the day after medical procedures can significantly reduce the risk of getting endocarditis.

Symptoms of Endocarditis

The symptoms of endocarditis include:

  • High fever or persistent low-grade fever
    Fever occurs when the body's immune system fights off the bacterial infection. In acute endocarditis, the onset is sudden and the fever is high whereas in subacute form, a low-grade fever may persist for days or weeks.
  • Swelling and redness of the fingers and toes
  • Fatigue or tiredness
  • Night sweats
  • Coughing
  • Shortness of breath
  • Joint pain and swelling
  • Stomach pain
  • Back pain

Endocarditis Diagnosis

Your doctor would look for the following signs in order to diagnose endocarditis:

  • Heart murmur
  • Roth spots or tiny hemorrhages or bleeding at the back of the eye
  • Tiny bleeding under the fingernails and/or toenails (splinter hemorrhage)
  • Elevated levels of white blood cell
  • Elevated sedimentation rate, a measure of infection or inflammation
  • Presence of bacteria in blood culture

Treatment for Endocarditis

Treatment for this serious condition includes:

  • Hospitalization
  • Intravenous antibiotic therapy
  • Oral antibiotic medications after hospital discharge

If damage occurs to the heart valve, or if the condition does not improve after 10 days of antibiotics treatment, then a surgery may be necessary to repair or replace the heart valve and correct the heart defect.

Prognosis

Endocarditis is fatal if not treated, especially for those with heart defects. However, if caught early and treated with antibiotics, the prognosis is good.







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