Infective endocarditis
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Infective endocarditis is an infection of the inner surface of the heart, usually the valves.[1] Signs and symptoms may include fever, small areas of bleeding into the skin, heart murmur, feeling tired, and low red blood cell count.[1][8] Complications may include backward blood flow in the heart, heart failure – the heart struggling to pump a sufficient amount of blood to meet the body's needs, abnormal electrical conduction in the heart, stroke, and kidney failure.[1][2][8][9]
Infective endocarditis | |
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Other names | Bacterial endocarditis |
A mitral valve vegetation caused by bacterial endocarditis. | |
Specialty | Cardiology, infectious disease |
Symptoms | Fever, small areas of bleeding into the skin, heart murmur, feeling tired, low red blood cells[1] |
Complications | Valvular insufficiency, heart failure, stroke, kidney failure[1][2] Blood clot in a lung artery (pulmonary embolism)[3] Enlarged and painful spleen, kidney damage, damage to the distal extremities such as fingers and toes.[4] |
Causes | Bacterial infection, fungal infection[1] |
Risk factors | Valvular heart disease including rheumatic disease, congenital heart disease,[5] artificial valves, hemodialysis, intravenous drug use, electronic pacemakers[6][7] |
Diagnostic method | Based on symptoms, blood cultures, ultrasound[1] |
Treatment | Antibiotics, heart surgery[1] |
Prognosis | 25% risk of death[6] |
Frequency | 5 per 100,000 per year[6] |
The cause is typically a bacterial infection and less commonly a fungal infection.[1] Risk factors include valvular heart disease, including rheumatic disease, congenital heart disease, artificial valves, hemodialysis, intravenous drug use, and electronic pacemakers.[6][10][5] The bacteria most commonly involved are streptococci or staphylococci.[1] Diagnosis is suspected based on symptoms and supported by blood cultures or ultrasound of the heart.[1] There is also a noninfective form of endocarditis.[1]
The usefulness of antibiotics following dental procedures for prevention is unclear.[11] Some recommend them for people at high risk.[1] Treatment is generally with intravenous antibiotics.[1] The choice of antibiotics is based on the results of blood cultures.[1] Occasionally heart surgery is required.[1] The number of people affected is about 5 per 100,000 per year.[6] Rates, however, vary between regions of the world.[6] Infective endocarditis occurs in males more often than in females.[1] The risk of death among those infected is about 25%.[6] Without treatment, it is almost universally fatal.[1] Improved diagnosis and treatment options have significantly enhanced the life expectancy of patients with infective endocarditis, particularly with congenital heart disease.[5]