Bacterial Endocarditis

What is bacterial endocarditis?

Bacterial endocarditis is an infection the membrane that covers the inner surface of the heart (endocardium).

Bacterial endocarditis is caused by specific bacteria which can travel to the heart through the blood. It can enter the blood from an infection somewhere else in the body. It can also enter during an activity that causes breaks in the skin or tissues. This activity can be dental work, surgery, or IV drug use.

The bacteria may be able to attach to the endocardium. Some heart conditions can increase the chance of infections. These conditions may cause blood flow to be blocked or to pool. This provides a place for the bacteria to build up.

What are the risk factors for bacterial endocarditis?

The following conditions put you at greater risk during certain procedures:

• Heart valve scarring, due to rheumatic fever or other conditions.
• Artificial heart valve.
• Heart defect present at birth.
• Cardiomyopathy.
• Prior episode of endocarditis.
• Mitral valve prolapse, with significant regurgitation (abnormal backflow of blood).

The conditions listed above increase your risk of the infection with certain activities such as:

• IV drug use—risk is very high when needles are shared.
• Any dental procedure, even cleanings.
• Removal of tonsils or adenoids, and other procedures involving the ears, nose, and throat.
• Viewing the airways though a thin, lighted tube— bronchoscopy.
• Surgery on the gastrointestinal or urinary tracks, including the gallbladder and prostate.

How is bacterial endocarditis diagnosed?

To test for bacterial endocarditis, your healthcare provider will perform a physical exam and listen to your heart for a murmur.

Other tests they may perform include:

• Blood tests.
• Blood cultures.
• Electrocardiogram (EKG).
• Imaging tests, like a CT scan.
• Echocardiogram.
• Transesophageal echocardiogram.

How is bacterial endocarditis treated?

Treatment will focus on getting rid of the infection in the blood and heart.

• Medication: Bacterial endocarditis requires hospitalization for treatment. Antibiotics are given through an IV. This therapy may last for four to six weeks.
• Surgery: The antibiotics may not remove the bacteria or the infection may return. In this case, surgery may be needed. Surgery may also be needed if there was damage done to the heart or valves from the infection.

When should I contact my healthcare provider?

Make an appointment with your healthcare provider if you have any of the following symptoms related to bacterial endocarditis:

• Fever.
• Chills.
• Fatigue.
• Weakness.
• Discomfort.
• Unexplained weight loss.
• Poor appetite.
• Muscle aches.
• Joint pain.
• Coughing.
• Shortness of breath.
• Little red dots on the skin, inside the mouth, and/or under the nails.
• Bumps on the fingers and toes.