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Infective Endocarditis

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Infective Endocarditis

When bacteria circulating in the bloodstream adhere to the valves of the heart or other parts of the heart's inner lining (the endocardium), bacterial endocarditis occurs. With adherence, vegetations of bacteria and fibres become vegetations of dead tissue. Bacteria may adhere to the endocardium of damaged heart valves and cause erosion and destruction. Infections of the heart valves occur most often with bacteria that gain access to the blood after tooth extraction, intravenous therapy, surgery, or anemia, or after the use of bacteria-contaminated material in drug abuse. Bacterial endocarditis is frequent in patients who have suffered acute rheumatic fever or congenital heart disease.

Patients with bacterial endocarditis have symptoms of high fever, hemorrhages in the skin, meningitis, infectious arthritis, and a newly developed heart murmer. The disease is very serious and can cause cardiac failure. Small clots of thrombin (the enzyme of the blood that causes clotting) may break off and travel by the bloodstream to other parts of the body, cutting off the blood supply and causing tissue death. Diagnosis is established by blood culture and physical examination. Treatment consists of the use of intravenous antibiotics for four to six weeks or longer. If severe erosion of the valves and resultant cardiac failure occur, surgical replacement of the damaged valve with an artificial one may be necessary.

Fungal endocarditis primarily strikes people who have undergone heart surgery and can also occur in intravenous-drug abusers. Symptoms are the same as those of bacterial endocarditis. Treatment consists of the use of appropriate antifungal agents. Prognosis is poor, however, and survival rates are less than 50 percent.

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