Medical Conditions



Bacterial Endocarditis

What is bacterial endocarditis?

Bacterial endocarditis is an infection of the inner lining of the heart chambers and valves. Bacterial endocarditis does not occur very often, but when it does, it can cause serious heart damage.

How does the infection occur?

Bacterial endocarditis occurs when bacteria (germs) enter the bloodstream and attach inside the heart, where they multiply and cause infection.

A normal heart has a smooth lining, making it difficult for bacteria to stick to it. However, persons with structural heart conditions or damage may have a rough area on the heart lining. These rough areas inside the heart are inviting, opportune places for bacteria to build up and multiply.

How does the bacteria get inside the body?

Bacteria can enter the body in many ways. According to the American Heart Association (AHA), some of the most common ways include the following:

  • Dental procedures (including professional teeth cleaning)
  • Tonsillectomy or adenoidectomy
  • Examination of the respiratory passageways with an instrument known as a rigid bronchoscope
  • Certain types of surgery on the respiratory passageways, the gastrointestinal tract, or the urinary tract
  • Gallbladder or prostate surgery

Who is at risk for bacterial endocarditis?

Individuals with congenital heart disease (CHD) may be at increased risk of developing an infection inside the heart. Other congenital conditions that remain at risk are those with residual defects causing turbulent blood flow through heart chambers and/or areas of surgical repair with artificial materials, such as patches or valve replacements.

Sometimes, doctors recommend antibiotics prior to dental procedures for those children at high risk for bacterial endocarditis. However, this is usually only for heart conditions associated with the highest risk of complications from endocarditis. You will need to discuss your child’s heart condition with his or her health care provider to determine if your child needs antibiotic prevention prior to dental procedures or other medical procedures.

In general, antibiotic prophylaxis is now recommended for:

  • Prosthetic (artificial) heart valves
  • A previous history of endocarditis
  • Some congenital heart disease
  • Heart transplantation recipients with heart valve disease

Consult your child's health care provider with any further questions you may have about risk factors.

How is bacterial endocarditis diagnosed?

In addition to a complete medical history and physical examination of your child, diagnostic procedures may include:

  • Echocardiogram (echo). A procedure that evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves.
  • Complete blood count (CBC). A measurement of size, number, and maturity of different blood cells in a specific volume of blood.
  • Blood culture. A test that assesses for and determines the specific type of bacteria in the bloodstream, if any.

How is bacterial endocarditis prevented?

Bacterial endocarditis cannot be entirely prevented, but helping your child maintain excellent oral hygiene is an important step in preventing bacterial endocarditis. Regular visits to the dentist for professional cleaning and check-ups are essential. In addition, if applicable, education and awareness of your child's heart condition, and the need for antibiotics prior to dental and medical procedures, can be helpful for your chid's health care providers.

Treatment for bacterial endocarditis

Your child's health care provider will determine specific treatment for bacterial endocarditis, but this infection is serious. It can cause severe damage to the inner lining of the heart and to the valves. The infection can be treated in most cases with strong antibiotics given through an IV over the course of several weeks. However, heart damage may occur before the infection can be controlled. Surgery may ultimately be required to repair or replace a damaged heart valve. Consult your child's health care provider for more information.

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Last reviewed: 4/26/2013