Bacterial Endocarditis (2022)

Continuing Education Activity

Bacterial endocarditis refers to infection of the endocardial surface of the heart. It usually involves heart valves, but it can occur on the endocardium or intracardiac devices. Acute endocarditis is a febrile illness that rapidly damages cardiac structures and spreads hematogenously which can progress to death within weeks if not treated. Subacute endocarditis has a slower disease process and may be present for weeks to months with gradual progression unless complicated by major embolic event or ruptured structure. This activity reviews the cause, pathophysiology, and presentation of bacterial endocarditis and highlights the role of the interprofessional team in its management.

Objectives:

  • Identify the etiology of bacterial endocarditis.

  • Review the presentation of a patient with bacterial endocarditis.

  • Summarize the treatment and management options available for bacterial endocarditis.

  • Explain the interprofessional team strategies for improving care coordination and communication regarding the management of patients with bacterial endocarditis.

Access free multiple choice questions on this topic.

Introduction

Bacterial endocarditis refers to infection of the endocardial surface of the heart. It usually involves heart valves, but it can occur on the endocardium or intracardiac devices.

There are two types:

  • Acute endocarditis is a febrile illness that rapidly damages cardiac structures and spreads hematogenously which can progress to death within weeks if not treated.

  • Subacute endocarditis has a slower disease process and may be present for weeks to months with gradual progression unless complicated by major embolic event or ruptured structure.[1]

Etiology

Most cases are caused by viridans streptococci, Streptococcus gallolyticus, Staphylococcus aureus, coagulase-negative staphylococci, HACEK organisms (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella), and enterococci. Rarer organisms include pneumococci, Candida, gram-negative bacilli, and polymicrobial organisms.[1]

Epidemiology

In developed countries, the incidence of endocarditis ranges from 2.6 to 7 cases per 100,000 population per year. The median age of patients with endocarditis is 58 years.

Risk factors

Age greater than 60 years, male gender, injection drug use, history of prior infective endocarditis, poor dentition or dental procedure, presence of a prosthetic valve or intracardiac device, history of valvular disease (rheumatic heart disease, mitral valve prolapse, aortic valve disease, mitral regurgitation, etc), congenital heart disease (aortic stenosis, bicuspid aortic valve, pulmonary stenosis, ventricular septal defect, patent ductus arteriosus, coarctation of the aorta, and tetralogy of Fallot), indwelling intravenous catheter, immunosuppression, hemodialysis patients.[2]

Pathophysiology

Endothelial injury allows for either direct infection by virulent organisms or the development of uninfected platelet-fibrin thrombus which becomes a nidus for transient bacteremia, except in the case of S. aureus, which can infect intact endothelium. These organisms enter the bloodstream from the skin, mucosal surfaces or previously infected sites and adhere to nonbacterial thrombus due to valvular damage or turbulent blood flow. In the absence of host defenses, this organism is allowed to proliferate forming small colonies and shed in the bloodstream. Left-sided infection is much more common than right-sided infection, except among intravenous drug users.[3]

History and Physical

Fever is the most common symptom. It can be associated with chills, night sweats, anorexia, weight loss, loss of appetite, malaise, headache, myalgias, arthralgias, abdominal pain, dyspnea, cough, and pleuritic pain.

Cardiac murmurs are observed in about 85% of patients. Congestive heart failure develops in 30% to 40% of patients usually due to valvular dysfunction. Other signs include cutaneous manifestations such as petechiae or splinter hemorrhages (non-blanching linear reddish-brown lesions under the nail bed).

Complications include conduction disease (first-degree atrioventricular block, bundle branch block, or complete heart block), ischemia (emboli to the coronary arteries), embolic stroke, intracerebral hemorrhage, brain abscess, septic emboli leading to infarction of the kidneys, spleen, lungs and other organs, hematogenous spread of infection leading to vertebral osteomyelitis, septic arthritis, or psoas abscess and systemic immune reaction such as glomerulonephritis.[4]

(Video) Infective Endocarditis, Animation

Evaluation

Definite Infective Endocarditis

Pathologic criteria: Pathologic lesions such as vegetation or intracardiac abscess demonstrating active endocarditis on histology or microorganisms demonstrated by culture or histology of vegetation or intracardiac abscess

Clinical criteria: Two major clinical criteria or one major and three minor clinical criteria or five minor clinical criteria

Possible infective Endocarditis

One major and one minor clinical criteria or the presence of three minor clinical criteria

Rejected Diagnosis of Infective Endocarditis

If an alternate diagnosis is established, if there is the resolution of clinical manifestations with less than or equal to 4 days of antibiotic therapy, if there is no pathological evidence of infective endocarditis found at surgery or autopsy after antibiotic therapy forenterococci4 days, or if clinical criteria for possible or definite infective endocarditis is not met

Major Clinical Criteria:

Positive blood cultures (one of the following):

  • Typical microorganisms for infective endocarditis from two separate blood cultures (S. aureus, Viridans streptococci, Streptococcus gallolyticus, HACEK group), or community-acquired enterococci in the absence of a primary focus) OR

  • Persistently positive blood culture with organisms that are typical causes of endocarditis from blood cultures drawn greater than 12 hours apart or all of three or a majority of equal to or greater than 4 separate blood cultures for organisms that are more common skin contaminants OR

  • Single positive blood culture for Coxiella burnetii or phase I IgG antibody titer greater than 1:800[5][3]

Evidence of endocardial involvement (one of the following):

  • Echocardiography positive for oscillating intracardiac mass on a valve or supporting structures or in the path of regurgitant jets, or on implanted material, in the absence of an alternative anatomic explanation or abscess or new partial dehiscence of prosthetic valve

  • New valvular regurgitation

Minor Clinical Criteria:

  • Predisposition: Intravenous drug use or presence of a predisposing heart condition

  • Fever: Temperature greater than or equal to 38.0 C (100.4 F)

    (Video) Infective Endocarditis

  • Vascular phenomena: Major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, or Janeway lesions (non-tender erythematous macules on the palms and soles)

  • Immunologic phenomena: Glomerulonephritis, Osler nodes (tender subcutaneous violaceous nodules mostly on the pads of the fingers and toes, which may also occur on the thenar and hypothenar eminences), Roth spots (exudative, edematous hemorrhagic lesions of the retina with pale centers), or rheumatoid factor

  • Microbiologic evidence: Positive blood cultures not meeting major criterion or serologic evidence of active infection with organism consistent with infective endocarditis[5][3]

Blood Cultures

At least three sets of blood cultures, separated from one another by at least 1 hour, should be obtained from separate venipuncture sites before initiation of antibiotic therapy. If cultures remain negative after 48 to 72 hours, two or three additional blood cultures should be obtained.

Culture-negative endocarditis is defined as endocarditis with no definitive microbiologic etiology after at least three independently obtained blood cultures. Up to 14% of patients may have negative blood cultures due to previous antibiotics therapy or due to fastidious organisms such as Coxiella, Legionella, Bartonella, Mycoplasma, Brucella, Chlamydia, and fungi.

Diagnostic Imaging

Echocardiography should be performed in all patients with suspected bacterial endocarditis. In general, transthoracic echocardiography (TTE) is the first diagnostic test; however, transesophageal echocardiography (TEE) has higher sensitivity than TTE and is better for detection of cardiac complications such as abscess, leaflet perforation, and pseudoaneurysm. TTE is inadequate for detecting small vegetations (less than 2 mm), evaluating prosthetic valves and may be technically inadequate due to lung disease or body habitus.

Patients with a negative TEE for whom the clinical suspicion for IE is high should undergo repeat TEE 7 to 10 days later. Repeat TEE is also warranted after an initial positive TEE if clinical features suggest the new development of an intracardiac complication.

Laboratory Findings

Laboratory data are usually nonspecific. Positive findings may include elevated inflammatory markers (erythrocyte sedimentation rate and/or elevated C-reactive protein), normochromic-normocytic anemia, positive rheumatoid factor, hypergammaglobulinemia, cryoglobulinemia, circulating immune complexes, hypocomplementemia, and false-positive serologic tests for syphilis. Urinalysis may demonstrate proteinuria, microscopic hematuria, and/or pyuria.[5]

Treatment / Management

Empiric antibiotic therapy should cover Staphylococcus (methicillin-susceptible and resistant), Streptococcus, and Enterococcus. Initial treatment with vancomycin and gentamicin should cover a number of organisms prior to the results of blood cultures.

The duration of therapy depends on the pathogen and site of valvular infection. The duration of therapy should be counted from the first day of negative blood cultures. Most patients are treated parenterally with regimens for up to 6 weeks.

Patients with relapse of native valve endocarditis following completion of appropriate antimicrobial therapy should receive a repeat course of antibiotics.[6][7][8]

Treatment of specific organisms:

  • Methicillin-sensitive S. aureus: nafcillin or oxacillin

If nonsevere penicillin allergy: cefazolin

If severe penicillin allergy: vancomycin and daptomycin

  • Methicillin-resistant S. aureus or coagulase-negative staphylococci: vancomycin for 6 weeks

  • Viridans streptococci and S. gallolyticus: penicillin G or ceftriaxone for 4 weeks.

If penicillin-resistant: penicillin G for four weeks plus gentamicin for the first two weeks.

(Video) Clinician's Corner: Endocarditis

Penicillin allergy: vancomycin

  • S. pneumoniae: penicillin G, cefazolin, or ceftriaxone for four weeks

Penicillin allergy: vancomycin

  • Enterococcal species: penicillin or ampicillin plus gentamicin for 4 to 6 weeks

Penicillin allergy: vancomycin plus gentamicin for 6 weeks.

  • Vancomycin-resistant enterococcus:linezolid or quinupristin-dalfopristin or imipenem

  • HACEK organisms: ceftriaxone, ampicillin or ciprofloxacin for 4 weeks

Differential Diagnosis

  • Antiphospholipid syndrome

  • Atrial myxoma

  • Connective tissue disease

  • Fever of unknown origin

  • Infective endocarditis

  • Intraabdominal infections

  • Marantic endocarditis

  • Physical medicine and rehabilitation for systemic lupus erythematosus

  • Polymyalgia rheumatica

Enhancing Healthcare Team Outcomes

The diagnosis and management of bacterial endocarditis is with an interprofessional team that includes an infectious disease expert, cardiologist, cardiac surgeon, internist, nurse practitioner, and the primary care provider. Once the diagnosis is made the treatment depends on the status of the valve.

Empiric antibiotic therapy should coverStaphylococcus(methicillin-susceptible and resistant),Streptococcus, andEnterococcus. Initial treatment with vancomycin and gentamicin should cover a number of organisms prior to the results of blood cultures.

The duration of therapy depends on the pathogen and site of valvular infection. The duration of therapy should be counted from the first day of negative blood cultures. Most patients are treated parenterally with regimens for up to 6 weeks.

(Video) Infective Endocarditis (IE): Pathology – Infectious Diseases | Lecturio

Patients with relapse of native valve endocarditis following completion of appropriate antimicrobial therapy should be considered for surgery.[6][7][8]The prognosis for patients with bacterial endocarditis depends on the age, number of valves infected, comorbidity, number of other organs affected and any neurological deficit.[9][10]

Figure

Table 1. Etiologic agents of infective endocarditis in the Pediatric population. Contributed by Olga Brea Pena, MD.

References

1.

Galar A, Weil AA, Dudzinski DM, Muñoz P, Siedner MJ. Methicillin-Resistant Staphylococcus aureus Prosthetic Valve Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management. Clin Microbiol Rev. 2019 Mar 20;32(2) [PMC free article: PMC6431130] [PubMed: 30760474]

2.

Kiyota Y, Della Corte A, Montiero Vieira V, Habchi K, Huang CC, Della Ratta EE, Sundt TM, Shekar P, Muehlschlegel JD, Body SC. Risk and outcomes of aortic valve endocarditis among patients with bicuspid and tricuspid aortic valves. Open Heart. 2017;4(1):e000545. [PMC free article: PMC5471870] [PubMed: 28674620]

3.

Jia Y, Fang F, Wang H. [The clinical and pathological features of patients with infective endocarditis diagnosed at autopsy]. Zhonghua Nei Ke Za Zhi. 2017 Oct 01;56(10):725-728. [PubMed: 29036951]

4.

Küçükoğlu R, Kılıç S, Sun GP. Infective endocarditis in two patients with pemphigus vulgaris under multiagent immunosuppressive drug therapy: A rare entity to remember in the differential diagnosis of fever of unknown origin. Dermatol Ther. 2019 May;32(3):e12860. [PubMed: 30758911]

5.

El Chami S, Jibbe A, Shahouri S. Bacterial Endocarditis Presenting as Leukocytoclastic Vasculitis. Cureus. 2017 Jul 13;9(7):e1464. [PMC free article: PMC5597063] [PubMed: 28936376]

6.

Maskarinec SA, Thaden JT, Cyr DD, Ruffin F, Souli M, Fowler VG. The Risk of Cardiac Device-Related Infection in Bacteremic Patients Is Species Specific: Results of a 12-Year Prospective Cohort. Open Forum Infect Dis. 2017 Summer;4(3):ofx132. [PMC free article: PMC5570037] [PubMed: 28852678]

7.

Spittle LS, Muzzin KB, Campbell PR, DeWald JP, Rivera-Hidalgo F. Current prescribing Practices for Antibiotic Prophylaxis: A Survey of Dental Practitioners. J Contemp Dent Pract. 2017 Jul 01;18(7):559-566. [PubMed: 28713108]

8.

Han SM, Sorabella RA, Vasan S, Grbic M, Lambert D, Prasad R, Wang C, Kurlansky P, Borger MA, Gordon R, George I. Influence of Staphylococcus aureus on Outcomes after Valvular Surgery for Infective Endocarditis. J Cardiothorac Surg. 2017 Jul 20;12(1):57. [PMC free article: PMC5520392] [PubMed: 28728556]

9.

Yanagawa B, Mazine A, Tam DY, Jüni P, Bhatt DL, Spindel S, Puskas JD, Verma S, Friedrich JO. Homograft Versus Conventional Prosthesis for Surgical Management of Aortic Valve Infective Endocarditis: A Systematic Review and Meta-analysis. Innovations (Phila). 2018 May/Jun;13(3):163-170. [PubMed: 29912740]

10.

He PC, Wei XB, Luo SN, Chen XL, Ke ZH, Yu DQ, Chen JY, Liu YH, Tan N. Risk prediction in infective endocarditis by modified MELD-XI score. Eur J Clin Microbiol Infect Dis. 2018 Jul;37(7):1243-1250. [PubMed: 29594801]

(Video) Endocarditis : causes, symptoms, pathophysiology, diagnosis and treatment

FAQs

Can you fully recover from endocarditis? ›

Most people who are treated with the proper antibiotics recover. But if the infection isn't treated, or if it persists despite treatment (for example, if the bacteria are resistant to antibiotics), it's usually fatal.

How long does it take to recover from bacterial endocarditis? ›

You can expect to take antibiotics for two to eight weeks to get rid of your infection. Most people survive endocarditis when they get aggressive treatment, but your risk of endocarditis being fatal depends on: Your age. Whether you have an artificial valve in your heart.

How serious is bacterial endocarditis? ›

Endocarditis occurs when bacteria or other germs enter the bloodstream and travel to the heart. The germs then stick to damaged heart valves or damaged heart tissue. Endocarditis is a life-threatening inflammation of the inner lining of the heart's chambers and valves.

Can bacterial endocarditis be cured? ›

Many people with endocarditis are successfully treated with antibiotics. Sometimes, surgery may be needed to fix or replace damaged heart valves and clean up any remaining signs of the infection.

Can you live a normal life after endocarditis? ›

You will need a follow up with blood tests and echocardiogram after you complete the treatment to make sure that the infection has cleared from your bloodstream and to check your heart valves. After the infection clears and if the echocardiogram shows good results, you may go back to your normal life.

What percentage of people survive endocarditis? ›

Conclusions: Long term survival following infective endocarditis is 50% after 10 years and is predicted by early surgical treatment, age < 55 years, lack of congestive heart failure, and the initial presence of more symptoms of endocarditis.

How long can you have bacterial endocarditis? ›

There are two forms of infective endocarditis, also known as IE: Acute IE — develops suddenly and may become life threatening within days. Subacute or chronic IE (or subacute bacterial endocarditis) — develops slowly over a period of weeks to several months.

How long are you in hospital with endocarditis? ›

How Is Endocarditis Treated? In most cases, your doctor will prescribe antibiotics. Usually, you will stay in the hospital for about a week to receive them through an IV. You may need IV antibiotics for between 2 and 6 weeks, but some of that might be from home.

How long do you need antibiotics for endocarditis? ›

You'll usually have to take antibiotics for 2 to 6 weeks. If your blood sample shows that fungi are causing your infection, you'll be prescribed an antifungal medicine.

What is the most common cause of endocarditis? ›

Bacterial infection is the most common cause of endocarditis. Endocarditis can also be caused by fungi, such as Candida. In some cases, no cause can be found.

Can you survive endocarditis without treatment? ›

Untreated, most patients with infective endocarditis will die. The infection can lead to damage of the heart valve(s) that in turn causes severe leaking (regurgitation) of blood back through the valve(s) and an inability of the heart to efficiently pump blood to the body.

What are the warning signs of endocarditis? ›

The most common symptoms of endocarditis include:
  • a high temperature.
  • chills.
  • night sweats.
  • headaches.
  • shortness of breath, especially during physical activity.
  • cough.
  • tiredness (fatigue)
  • muscle and joint pain.

What happens if antibiotics don't work for endocarditis? ›

If the damage to your valves is severe, you may need heart valve surgery. This is done to repair or replace a damaged heart valve. Or you might need surgery to help clear the endocarditis. This may be done if the antibiotics don't work well enough on the infection.

What are the chances of getting endocarditis twice? ›

Three problems hamper the prognosis of patients who survive the initial phase of infective endocarditis (IE): the rate of IE recurrence is 0.3-2.5/100 patient years, about 60% of patients will have to be operated on at some time, 20-30% during the initial stay, 30-40% during the following 5-8 years; five-year survival ...

How do you get bacterial endocarditis? ›

Endocarditis is caused by bacteria in the bloodstream multiplying and spreading across the inner lining of your heart (endocardium). The endocardium becomes inflamed, causing damage to your heart valves. Your heart is usually well protected against infection so bacteria can pass harmlessly by.

What are the long term effects of endocarditis? ›

What are the long-term effects of endocarditis? A lot of people with endocarditis need surgery, due to damage to the heart valves caused by the infection. There are potential complications including stroke.

Can a tooth infection cause endocarditis? ›

A dental problem or procedure that results in an infection can trigger it. Poor health in the teeth or gums increases the risk of endocarditis, as this makes it easier for the bacteria to get in. Good dental hygiene helps prevent heart infection.

Can endocarditis symptoms come and go? ›

Infective endocarditis symptoms may progress slowly or come on suddenly. Sometimes symptoms come and go. Other signs

signs
A medical sign is an objective observable indication of a disease, injury, or abnormal physiological state that may be detected during a physical examination, examining the patient history, or diagnostic procedure. These signs are visible or otherwise detectable such as a rash or bruise.
https://en.wikipedia.org › wiki › Signs_and_symptoms
and symptoms of infective endocarditis include: Fatigue or weakness.

What are the chances of dying from endocarditis? ›

Despite modern antibiotic and surgical therapy, mortality rates remain as high as 25% for both native- and prosthetic-valve endocarditis, with death resulting primarily from central nervous system (CNS) embolic events and hemodynamic deterioration [2].

Can a blood test detect endocarditis? ›

Blood tests may be used to help diagnose endocarditis or identify the most effective treatment. Blood tests may include: a blood culture test to check for a specific bacteria or fungi. an erythrocyte sedimentation rate (ESR) test.

Does endocarditis require open heart surgery? ›

Early open heart surgery is recommended in bacterial endocarditis if heart failure is progressive. Shorter postoperative antibiotic therapy is proposed once the source of residual infection is removed.

Can a sinus infection cause endocarditis? ›

Colds and flu do not cause endocarditis, but infections that may have the same symptoms (sore throat, general body aches, and fever) do. To be safe call your provider.

Who is at high risk for infective endocarditis? ›

There are four main groups of people who are at risk for infective endocarditis. People with underlying heart problems such as congenital heart disease, valvular heart disease, hypertrophic cardiomyopathy, rheumatic heart disease, or previous bouts of endocarditis.

What does a heart infection feel like? ›

General symptoms of a heart infection include chest pain, fever, and shortness of breath. These symptoms can also be present with a life-threatening condition, such as heart attack. Seek immediate medical care if you, or someone you are with, have these symptoms.

When is surgery required for endocarditis? ›

Standard indications for surgery are severe heart failure, severe valve dysfunction, prosthetic valve infection, invasion beyond the valve leaflets, recurrent systemic embolization, large mobile vegetations, or persistent sepsis despite adequate antibiotic therapy for more than 5–7 days.

Why do you get night sweats with endocarditis? ›

The symptoms of infectious endocarditis are protean and include fever, chills, fatigue, sweats, and malaise. These night sweats may be related to nocturnal fever caused by transient bacteremia.

Does endocarditis show on ECG? ›

Your doctor may also order an electrocardiogram (EKG). An EKG monitors electrical activity in your heart. This painless test can find an irregular heartbeat caused by endocarditis.

What is the best antibiotic to treat endocarditis? ›

A combination of penicillin or ampicillin with gentamicin is appropriate for endocarditis caused by enterococci that are not highly resistant to penicillin. Vancomycin should be substituted for penicillin when high-level resistance is present.

Can you have endocarditis and not know it? ›

The symptoms of endocarditis aren't always severe, and they may develop slowly over time. In the early stages of endocarditis, the symptoms are similar to many other illnesses. This is why many cases go undiagnosed. Many of the symptoms are similar to cases of the flu or other infections, such as pneumonia.

Does endocarditis recur? ›

Results: Relapses were observed in 14 (3.3%) patients. There was one recurrence of endocarditis in 48 (11.4%) patients, two (0.5%) in 2 patients, three in 1 patient (0.2%), and five (0.2%) in 1 patient.

What are the long-term effects of endocarditis? ›

What are the long-term effects of endocarditis? A lot of people with endocarditis need surgery, due to damage to the heart valves caused by the infection. There are potential complications including stroke.

How long can endocarditis last? ›

Endocarditis is treated with long-term courses of intravenous antibiotics or antifungals. Each course can last as long as six weeks.

Can you get endocarditis twice? ›

Treatment includes a long course of antibiotics. Some people require heart surgery to remove the infection and repair the damage. Individuals who have had endocarditis once are more likely to have it a second time.

Can endocarditis symptoms come and go? ›

Infective endocarditis symptoms may progress slowly or come on suddenly. Sometimes symptoms come and go. Other signs

signs
A medical sign is an objective observable indication of a disease, injury, or abnormal physiological state that may be detected during a physical examination, examining the patient history, or diagnostic procedure. These signs are visible or otherwise detectable such as a rash or bruise.
https://en.wikipedia.org › wiki › Signs_and_symptoms
and symptoms of infective endocarditis include: Fatigue or weakness.

What is the most common cause of endocarditis? ›

Bacterial infection is the most common cause of endocarditis. Endocarditis can also be caused by fungi, such as Candida. In some cases, no cause can be found.

How long are you in hospital with endocarditis? ›

How Is Endocarditis Treated? In most cases, your doctor will prescribe antibiotics. Usually, you will stay in the hospital for about a week to receive them through an IV. You may need IV antibiotics for between 2 and 6 weeks, but some of that might be from home.

What are the warning signs of endocarditis? ›

The most common symptoms of endocarditis include:
  • a high temperature.
  • chills.
  • night sweats.
  • headaches.
  • shortness of breath, especially during physical activity.
  • cough.
  • tiredness (fatigue)
  • muscle and joint pain.

How do you get rid of endocarditis? ›

Most cases of endocarditis can be treated with a course of antibiotics. You'll usually have to be admitted to hospital so the antibiotics can be given through a drip in your arm (intravenously).

Can a tooth infection cause endocarditis? ›

A dental problem or procedure that results in an infection can trigger it. Poor health in the teeth or gums increases the risk of endocarditis, as this makes it easier for the bacteria to get in. Good dental hygiene helps prevent heart infection.

Who is at risk for bacterial endocarditis? ›

Two kinds of bacteria cause most cases of bacterial endocarditis. These are staphylococci (staph) and streptococci (strep). You may be at increased risk for bacterial endocarditis if you have certain heart valve defects. This gives the bacteria an easier place to take hold and grow.

How fast does endocarditis develop? ›

There are two forms of infective endocarditis, also known as IE: Acute IE — develops suddenly and may become life threatening within days. Subacute or chronic IE (or subacute bacterial endocarditis) — develops slowly over a period of weeks to several months.

What percentage of IV drug users get endocarditis? ›

The incidence of IE among IDU in the United States ranges between 1–5% every year. In IDU patients, IE accounts for 5–20% of hospitalizations and 5–10% of total deaths (4, 5). Historically, streptococci viridans was the most common pathogen that caused native valve IE.

What does bacterial endocarditis do to the heart? ›

These pieces, called emboli, can cause damage to organs such as the brain (a stroke), eyes, lungs, kidneys, spleen, liver, and intestines. Endocarditis can also cause heart rhythm changes that may require a pacemaker for correction.

Would endocarditis show up in blood work? ›

Blood tests may be used to help diagnose endocarditis or identify the most effective treatment. Blood tests may include: a blood culture test to check for a specific bacteria or fungi.

What does an infection of the heart feel like? ›

General symptoms of a heart infection include chest pain, fever, and shortness of breath. These symptoms can also be present with a life-threatening condition, such as heart attack. Seek immediate medical care if you, or someone you are with, have these symptoms.

Can you have endocarditis and not know it? ›

The symptoms of endocarditis aren't always severe, and they may develop slowly over time. In the early stages of endocarditis, the symptoms are similar to many other illnesses. This is why many cases go undiagnosed. Many of the symptoms are similar to cases of the flu or other infections, such as pneumonia.

Videos

1. Endocarditis Nursing Pathophysiology Treatment | Infective Endocarditis Lecture
(RegisteredNurseRN)
2. Endocarditis 101: Diagnosis and Treatment
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3. Infective Endocarditis (IE): Definition & Epidemiology– Infectious Diseases | Lecturio
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4. Endocarditis: Definition, Pathology, Classification & Diagnosis – Infectious Diseases | Lecturio
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5. Mitral Valve Bacterial Endocarditis: What Should Patients Know?
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6. Signs and Symptoms of Endocarditis (Mnemonic)
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