Endocarditis is inflammation of the inside lining of the heart chambers and heart valves (endocardium). It is caused by a bacterial or, rarely a fungal infection.
Valve infection; Staphylococcus aureus - endocarditis; Enterococcus - endocarditis; Streptococcus viridans - endocarditis; Candida - endocarditis
Endocarditis can involve the heart muscle, heart valves, or lining of the heart. Some people who develop endocarditis have a:
Endocarditis begins when germs enter the bloodstream and then travel to the heart.
Germs are most likely to enter the bloodstream during:
Symptoms of endocarditis may develop slowly or suddenly.
Fever, chills, and sweating are frequent symptoms. These sometimes can:
You may also have fatigue, weakness, and aches and pains in the muscles or joints.
Other signs can include:
Exams and Tests
The health care provider may detect a new heart murmur, or a change in a past heart murmur.
An eye exam may show bleeding in the retina and a central area of clearing. This finding is known as Roth spots. There may be small, pinpoint areas of bleeding on the surface of the eye or the eyelids.
Tests that may be done include:
You may need to be in hospital to get antibiotics through a vein (IV or intravenously). Blood cultures and tests will help your provider choose the best antibiotic.
You will then need long-term antibiotic therapy.
Surgery to replace the heart valve is often needed when:
Getting treatment for endocarditis right away improves the chances of a good outcome.
More serious problems that may develop include:
When to Contact a Medical Professional
Call your provider if you notice the following symptoms during or after treatment:
The American Heart Association recommends preventive antibiotics for people at risk for infectious endocarditis, such as those with:
These people should receive antibiotics when they have:
Baddour LM, Freeman WK, Suri RM, Wilson WR. Cardiovascular infections. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 64.
Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2015;132(15):1435-1486. PMID: 26373316 www.ncbi.nlm.nih.gov/pubmed/26373316.
Fowler VG Jr, Scheld WM, Bayer AS. Endocarditis and intravascular infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 82.
Review Date: 11/27/2016
Reviewed By: Arnold Lentnek, MD, Infectious Diseases Medical Practice of NY and Clinical Research Centers of CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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