Infective endocarditis is an infection of the lining of the heart chambers and heart valves that is caused by bacteria, fungi, or other infections.
Endocarditis is usually a result of a blood infection. Bacteria or other infectious substances can enter the bloodstream during certain medical procedures, including dental procedures and travel to the heart, where it can settle on damaged heart valves. The bacteria can grow and may form infected clots that break off and travel to the brain, lungs, kidneys, or spleen.
Most people who develop infectious endocarditis have underlying heart disease or valve problems.
However, an organism commonly found in the mouth, Streptococcus viridans, is responsible for about 50% of all bacterial endocarditis cases. This is why dental procedures increase your chances for developing this condition. Such procedures are especially risky for children with congenital heart conditions. As a result, it is common practice for children with some forms of congenital heart disease and adults with certain heart-valve conditions to take antibiotics before any dental work.
Other common culprits include Staphylococcus aureus and enterococcus. Staphylococcus aureus can infect normal heart valves, and is the most common cause of infective endocarditis in intravenous drug users.
Less common causes of infective endocarditis include pseudomonas, serratia, and candida. Intravenous drug users are also at risk for this condition, because unsterile needles can cause bacteria to enter the bloodstream.
Symptoms of endocarditis may develop slowly (subacute) or suddenly (acute). Fever is the classic symptom and may persist for days before any other symptoms appear.
Other symptoms may include:
- Abnormal urine color
- Blood in the urine
- Excessive sweating
- Joint pain
- Muscle aches and pains
- Nail abnormalities (splinter hemorrhages under the nails)
- Night sweats (may be severe)
- Red, painless skin spots on the palms and soles (Janeway lesions)
- Red, painful nodes (Osler's nodes) in the pads of the fingers and toes
- Shortness of breath with activity
- Swelling of feet, legs, abdomen
- Weight loss
Call your health care provider if you have symptoms of infectious endocarditis.
You may be admitted to the hospital so you can receive antibiotics through a vein. Long-term, high-dose antibiotic treatment is needed to get rid of the bacteria. Treatment is usually given for 4 - 6 weeks, depending on the specific type of bacteria. Blood tests will help your doctor choose the best antibiotic.
Surgery may be needed to replace damaged heart valves.
Texas Health is committed to providing quality care to heart and vascular patients throughout North Texas and beyond. While various technologies and services are discussed here, not all of our hospitals offer every treatment and diagnostic technology highlighted. Call 1-877-THR-WELL to learn more about heart and vascular services at a Texas Health hospital near you.