Infective endocarditis is an infection of the lining of the heart
chambers and heart valves that is caused by bacteria, fungi, or
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
- Red, painful nodes (Osler's nodes) in the pads of the fingers
- Shortness of breath with activity
- Swelling of feet, legs, abdomen
- Weight loss
Call your health care provider if you have symptoms of infectious
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
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.