Valve infection; Staphylococcus aureus - endocarditis; Enterococcus - endocarditis; Streptococcus viridans - endocarditis; Candida - endocarditis
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.
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:
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's 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 usually needed when:
Getting treatment for endocarditis right away improves the chances of a good outcome.
More serious problems that may develop include:
Call your health care 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.
Fowler VG Jr, Scheld WM, Bayer AS. Endocarditis and Intravascular Infections. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009; chapt 77.
Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007 Oct 9;116(15):1736-54.
Last reviewed on: 12/7/2014
Reviewed by: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.