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INFECTIVE ENDOCARDITIS
| One of the symptoms of infective endocarditis is a low grade fever of unknown origin, for an extended period of time. Temperatures vary with different people but the average is 98.6. If you have a temperature of 99 or 100 suspect a fever, 100 or higher is a fever. A low grade fever is 102 or lower (depending on your normal temperature). A high fever is over 103. Your temperature will vary throughout the day. |
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The usual defense on the part of the doctor when a patient dies from Infective Endocarditis or in cases of valvular damage, is that IE is a hard disease to detect. This is simply not true. The truth is, that if the doctors cannot detect this disease, the patient had better be able to do so, and be able to tell their doctor what tests need to be done to uncover this disease. This knowledge can make the difference between having your own valve, or an animal or artificial valve and ultimately between life and death. It is hoped that a patient with MVP who is diagnosed by their doctor for "flu", viral infection, even the common cold, sore throat or tonsillitis, while having a fever, protest vigorously and effectively and demand a thorough investigation. |
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DEFINITION:
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Endocarditis is caused by bacteria that enters the bloodstream which transports them to the heart. It is an inflammation of the smooth endothelial tissue that lines the myocardium and covers the valves. The bacteria becomes embedded inside layers of necrotic , cellular debris cast off by the body, platelets, fibrin, white and red blood cells and strands of collagen. The result is called vegetation, or endocarditic lesion. These vegetations are engrafted the sites in the heart and on the valves. |
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CAUSES: |
Sources of the infection may be transient bacteria, common from dental work, upper respiratory, urologic and lower gastrointestinal diagnostic and surgical procedures. The infection causes growth on the heart valves, the lining of the heart or the lining of the blood vessels. These growths may dislodge and travel to the brain, lungs, kidneys or the spleen. |
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(see separate page also) |
Symptoms include,
fatigue, weakness, fever,
chills, night sweats, weight
loss, muscle aches and pains, heart
murmur, shortness of breath with activity,
swelling of feet, legs, or abdomen, blood in
urine, sweating, excessive, skin spots, red
on palms and soles -called Janeway lesions,
paleness, nail abnormalities, joint
pain, abnormal urine color, red painful nodes in
pads of fingers and toes-called Osler's nodes.
An enlarged spleen can be indicated by chest pain in the left upper quadrant of the body, with pain that radiates to the left shoulder. |
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PREVENTION: |
To prevent this infection one must take antibiotics before dental procedures or procedures involving the respiratory, urinary, or intestinal tract. |
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(see separate page also) |
Test performed by the doctor are, physical examination to detect enlarged spleen, check for change or new heart murmur, eye examination may show retinal hemorrhages, blood culture to determine if microorganisms are present in blood, ERS blood test for various inflammatory disease, CBC, a complete blood count, echocardiogram, chest x-ray, CT scan of the chest, also a blood test to check for antibodies in the blood. |
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TREATMENT:
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Treatment is long term
intravenous antibiotics. Therapy up to 6 weeks is common.
Repeated episodes or inadequately treated endocarditis, or delay in treatment can cause increasingly worse regurgitation. And therefore the risk of sudden death from arrhythmia or thromboembolism is greater. |
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COMPLICATIONS: |
Complications of the infection can be, congestive heart failure, blood clots causing damage to the brain, kidney, lung or abdomen, arrhythmias, glomerulonephrits (kidney disease), sever valve damage, stroke, brain abscess, neurological changes, jaundice |