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Infective endocarditis (IE) is an infection of the inner lining of the heart chambers (endocardium) and valves. This condition is sometimes called "endocarditis," although it is important to distinguish it from non-infective endocarditis. IE is caused by bacteria, fungi, or other germs invading the bloodstream and attaching to the heart. IE can damage the heart and cause serious and sometimes fatal complications. It can develop quickly or slowly depending on what type of germ is causing it and whether there is an underlying heart problem. Common symptoms of IE are fever and other flu-like symptoms, but signs and symptoms can vary. It can also cause problems in many other parts of the body besides the heart. IE is typically treated with antibiotics for several weeks; some individuals may need heart surgery to repair or replace heart valves or remove infected heart tissue.
Source: GARD Last updated on 05-01-20
Not all cases of infective endocarditis (IE) can be prevented, because it is difficult to always know know when bacteremia (bacteria in the bloodstream) occurs. IE is uncommon, but people with some heart defects have a greater risk of developing it. For most individuals, preventing IE involves maintaining good dental hygiene. Brushing, flossing, and visiting a dentist regularly helps prevent tooth and gum infections that could lead to endocarditis. In the past, individuals with nearly every type of congenital heart defect needed to receive antibiotics one hour before dental procedures or operations on the mouth, throat, gastrointestinal, genital, or urinary tract. However, the American Heart Association later simplified its recommendation. Today, antibiotics are typically only recommended for individuals with the highest risk of IE, those who have:
Some congenital heart defects can be successfully repaired surgically and the person will no longer be at risk for endocarditis. Examples include:
After the defects are completely repaired surgically, there is no longer an increased risk for endocarditis in these individuals.
People who have had endocarditis before are at high risk of getting it again. This is true even when they don’t have heart disease. Recurrent endocarditis is defined as repeated episodes of infection separated by intervals of at least 6 months or caused by different microorganisms. The number of individuals with recurrent IE is increasing as a result of improved treatment. It has been found that underlying abnormalities in cardiac structure and active intravenous drug abuse are associated with increased risk of recurrent IE. It has been proposed that failure to destroy a local area of bacteria may be responsible for recurrent IE caused by the same microorganism. Prolonged survival of individuals with recurrent IE is generally attributable to intense workups and early antimicrobial treatment, as well as prompt surgical intervention.
Last updated on 05-01-20
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