Bacterial endocarditis

Overview

Bacterial endocarditis is a rare but serious infection in the heart and/or valves. While this infection usually is associated with certain types of congenital heart defects, it also can occur in structurally normal hearts. Endocarditis may occur in the postoperative setting, affecting newly placed prosthetic valves and/or patch material.

Causes

Bacterial endocarditis can have a variety of causes:

  • Bacteria, fungi or other germs that get into your bloodstream and affix themselves to abnormal areas in your heart
  • A structural heart defect, particularly in a valve, which lessens the ability of your immune system to kill bacteria in your bloodstream, allowing them to grow in the heart
  • Gum disease or unhealthy teeth, conditions which can introduce bacteria into your bloodstream while brushing your teeth or undergoing dental procedures
  • A percutaneous device such as a catheter, especially if it remains in place for long periods, also can allow bacteria into your bloodstream. Other pathways for bacteria are mechanical implants such as artificial heart valves, pacemakers or implantable defibrillators.
  • Infections in other parts of the body, such as the skin or the genitals, can generate bacteria that can travel into the blood and heart.
  • Intravenous drug use, particularly when sharing needles and syringes.

Symptoms

Bacterial endocarditis can generate serious complications in the heart, central nervous system, lungs, kidneys and spleen, including stroke and the need for open heart surgery; it even can result in death.

Treatment

Bacterial endocarditis requires a long course of intravenous antibiotics over approximately six weeks. In some cases, surgery is required to resect damaged tissue or replace a damaged valve.

Prevention

Prevention of bacterial endocarditis is indicated in a subset of congenital heart defects. Your cardiologist will tell you if and when you require prophylactic antibiotics prior to other medical care, including dental visits or invasive urological procedures.

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