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Endocarditis

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Medical Author:

Daniel Lee Kulick, MD, FACC, FSCAI

Daniel Lee Kulick, MD, FACC, FSCAI

Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What is endocarditis?

Endocarditis is a serious infection of one of the four heart valves.

What causes endocarditis?

Endocarditis is caused by a growth of bacteria on one of the heart valves, leading to an infected mass called a "vegetation". The infection may be introduced during brief periods of having bacteria in the bloodstream, such as after dental work, colonoscopy, and other similar procedures.

What are the symptoms of endocarditis?

Patients with endocarditis can develop:

• fever,
  
  
• fatigue,
  
  
• chills,
  
  
• weakness
  
  
• aching joints and muscles,
  
  
• night sweats,
  
  
• edema (fluid collection) in the leg(s), foot (feet), and abdomen,
  
  
• malaise,
  
  
• shortness of breath, and
  
  
• occasionally, scattered small skin lesions.

In endocarditis, blood cultures can often detect the bacteria causing the endocarditis. Patients can also develop anemia, blood in urine, elevated white blood cell count, and a new heart murmur.

Who is at risk for endocarditis?

People with existing diseases of the heart valves (aortic stenosis, mitral stenosis, mitral regurgitation, etc.) and people who have undergone heart valve replacements are at an increased risk of developing endocarditis. These people are usually given antibiotics prior to any procedure which may introduce bacteria into the bloodstream. This includes routine dental work, minor surgery, and procedures that may traumatize body tissues such as colonoscopy and gynecologic or urologic examinations. Examples of antibiotics used include oral amoxicillin (Amoxil) and erythromycin (Emycin, Eryc,PCE), as well as intramuscular or intravenous ampicillin, gentamicin, and vancomycin.