EndocarditisSymptoms, Doctors, Treatments, Advances & More
Learn About Endocarditis
Endocarditis is inflammation of the inside lining of the heart chambers and heart valves (endocardium). It is most often 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:
- Birth defect of the heart
- Damaged or abnormal heart valve
- History of endocarditis
- New heart valve after surgery
- Parenteral (intravenous) drug use disorder or addiction
- Long-term intravenous line in place
Endocarditis begins when germs enter the bloodstream and then travel to the heart.
- 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.
Germs are most likely to enter the bloodstream during:
- Central venous access lines
- Injection drug use, from the use of unclean (unsterile) needles
- Recent dental surgery
- Other surgeries or minor procedures to the breathing tract, urinary tract, infected skin, or bones and muscles
Symptoms of endocarditis may develop slowly or suddenly.
Fever, chills, and sweating are frequent symptoms. These sometimes can:
- Be present for days before any other symptoms appear
- Come and go, or be more noticeable at nighttime
You may also have fatigue, weakness, weight loss, loss of appetite, and aches and pains in the muscles or joints.
Other signs can include:
- Small areas of bleeding under the nails (splinter hemorrhages)
- Red, painless skin spots on the palms and soles (Janeway lesions)
- Red, painful nodes in the pads of the fingers and toes (Osler nodes)
- Shortness of breath with activity
- Swelling of feet, legs, abdomen
You may need to be in the 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.
- People most often need therapy for 4 to 6 weeks to kill all the bacteria from the heart chambers and valves.
- Antibiotic treatments that are started in the hospital will need to be continued at home.
Surgery to replace the heart valve is often needed when:
- The infection is breaking off into little pieces, resulting in strokes or blockages of other arteries.
- The person develops heart failure as a result of damaged heart valves.
- There is evidence of more severe organ damage (such as heart damage).
Duke Infectious Diseases Clinic - Clinic 1K
I treat patients who have a variety of diseases including osteomyelitis, skin infections, device-related infections, infective endocarditis, and HIV. I am an associate professor in the Division of Infectious Diseases and my professional interests include patient care, clinical research and education. Dr. Chu is rated as an Elite provider by MediFind in the treatment of Endocarditis. She is also highly rated in 2 other conditions, according to our data. Her clinical expertise encompasses Endocarditis, Infective Endocarditis, Sepsis, and Mediastinitis. Dr. Chu is board certified in American Board Of Internal Med, Infectious Diseases.
Cleveland Clinic Main Campus
Steven Gordon is an Infectious Disease provider practicing medicine in Cleveland, Ohio. He has been practicing medicine for over 46 years. Dr. Gordon is rated as an Elite provider by MediFind in the treatment of Endocarditis. He is also highly rated in 7 other conditions, according to our data. His clinical expertise encompasses Infective Endocarditis, Endocarditis, Listeriosis, Thrombectomy, and Splenectomy. Dr. Gordon is board certified in American Board Of Internal Medicine, 1992.
Cleveland Clinic Main Campus
Brian Griffin is a Cardiologist practicing medicine in Cleveland, Ohio. Dr. Griffin is rated as an Elite provider by MediFind in the treatment of Endocarditis. He is also highly rated in 69 other conditions, according to our data. His clinical expertise encompasses Aortic Regurgitation, Mitral Valve Regurgitation, Aortic Valve Stenosis, Aortic Valve Replacement, and Transcatheter Aortic Valve Replacement (TAVR). Dr. Griffin is board certified in American Board Of Internal Medicine, 1993.
Getting treatment for endocarditis right away improves the chances of a good outcome.
More serious problems that may develop include:
- Brain abscess
- Further damage to the heart valves, causing heart failure
- Spread of the infection to other parts of the body
- Stroke, caused by small clots or pieces of the infection breaking off and traveling to the brain
Contact your provider if you notice the following symptoms during or after treatment:
- Blood in urine
- Chest pain
- Fatigue
- Fever that doesn't go away
- Fever
- Numbness
- Weakness
- Weight loss without change in diet
The American Heart Association recommends preventive antibiotics for people at risk for infectious endocarditis, such as those with:
- Certain birth defects of the heart
- Heart transplant and valve problems
- Prosthetic heart valves (heart valves inserted by a surgeon)
- Past history of endocarditis
These people should receive antibiotics when they have:
- Dental procedures that are likely to cause bleeding
- Procedures involving the breathing tract
- Procedures involving the urinary tract
- Procedures involving the digestive tract
- Procedures on skin infections and soft tissue infections
Summary: The primary objective of this study is to demonstrate that a rifampin-free regimen is non-inferior to the rifampin-containing regimen in terms of all-cause mortality in staphylococcal prosthetic valve endocarditis within 6 months after randomization.
Summary: Infectious endocarditis (IE) is the localization and proliferation of blood-borne germs in the endocardium. It remains a complicated disease to manage due to its low incidence, diagnostic difficulties, the change in epidemiology in recent decades and high mortality rates. The annual incidence is estimated at 3-10 cases per 100,000 people. The epidemiology of AR has changed significantly in recent ...
Published Date: November 10, 2024
Published By: Jatin M. Vyas, MD, PhD, Roy and Diana Vagelos Professor in Medicine, Columbia University Vagelos College of Physicians and Surgeons, Division of Infectious Diseases, Department of Medicine, New York, NY. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Baddour LM, Anavekar NS, Crestanello JA, Wilson WR. Infectious endocarditis and infections of indwelling devices. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 80.
Fowler VG, Bayer AS, Baddour LM. Infective endocarditis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 61.
Holland TL, Bayer AS, Fowler VG. Endocarditis and intravascular infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 80.