Subacute Bacterial Endocarditis



What is subacute bacterial endocarditis?

Endocarditis, also called infective endocarditis, is an infection and inflammation of the heart valves and the inner lining of the heart chambers, which is called the endocardium.

Endocarditis occurs when infectious organisms, such as bacteria or fungi, enter the bloodstream and settle in the heart. In most cases, these organisms are streptococci (“strep”), staphylococci (“staph”) or species of bacteria that normally live on body surfaces.

Depending on the aggressiveness of the infecting germ, the heart damage caused by endocarditis can be swift and severe (acute endocarditis) or slower and less dramatic (subacute endocarditis).

Subacute bacterial endocarditis usually is caused by a viridans streptococci – a type of bacteria; it occurs on damaged valves, and, if untreated, can become fatal within six weeks to a year.

How common is subacute bacterial endocarditis?

Subacute bacterial endocarditis can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.


What are the symptoms of subacute bacterial endocarditis?

The common symptoms of subacute bacterial endocarditis are:

  • Low-grade fever (less than 39 degree Celcius)
  • Chills
  • Night sweats
  • Pain in muscles and joints
  • A persistent tired feeling
  • Headache
  • Shortness of breath
  • Poor appetite
  • Weight loss
  • Small, tender nodules on the fingers or toes
  • Tiny broken blood vessels on the whites of the eyes, the palate, inside the cheeks, on the chest, or on the fingers and toes

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

See your doctor immediately if you experience shortness of breath or swelling in your legs, ankles or feet. These signs and symptoms may indicate heart failure.

If the infection damages your heart valves, you may have symptoms and complications for years after treatment.


What causes subacute bacterial endocarditis?

This form of endocarditis most often is caused by one of the viridans group of streptococci (Streptococcus sanguis, mutans, mitis or milleri) that normally live in the mouth and throat. Streptococcus bovis or Streptococcus equinus also can cause subacute endocarditis, typically in patients who have a gastrointestinal problem, such as diverticulitis or colon cancer.

Subacute endocarditis tends to involve heart valves that are abnormal, such as narrowed or leaky heart valves. Subacute bacterial endocarditis often causes non-specific symptoms that can persist for many weeks before a diagnosis is made.

Risk factors

What increases my risk for subacute bacterial endocarditis?

There are many risk factors for subacute bacterial endocarditis, such as:

  • Artificial heart valves. Germs are more likely to attach to an artificial (prosthetic) heart valve than to a normal heart valve.
  • Congenital heart defects. If you were born with certain types of heart defects, your heart may be more susceptible to infection.
  • A history of endocarditis. An episode of endocarditis damages heart tissue and valves, increasing the risk of a future heart infection.
  • Damaged heart valves. Certain medical conditions — such as rheumatic fever or infection — can damage or scar one or more of your heart valves, making them more prone to endocarditis.
  • History of intravenous (IV) illegal drug use. People who use illegal drugs by injecting them are at a greater risk of endocarditis. The needles used to inject drugs can be contaminated with the bacteria that can cause endocarditis.

Diagnosis & Treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.


How is subacute bacterial endocarditis diagnosed?

Your doctor may ask for your medical history and check for physical signs and symptoms, such as fever. Using a stethoscope to listen to your heart, your doctor may hear a new heart murmur or a change in a previous heart murmur — possible signs of endocarditis.

The infection can mimic other illnesses in its early stages. Various tests may be necessary to help make the diagnosis:

  • Blood tests
  • Transesophageal echocardiogram
  • Electrocardiogram (ECG)
  • Chest X-ray
  • Computerized tomography (CT) scan or magnetic resonance imaging (MRI)

How is subacute bacterial endocarditis treated?

The first line of treatment for endocarditis is antibiotics. Sometimes, if your heart valve is damaged by your infection, surgery is necessary.

If you have endocarditis, you may need high doses of intravenous (IV) antibiotics in the hospital. Blood tests may help identify the type of microorganism that’s infecting your heart. This information will help your doctor choose the best antibiotic or combination of antibiotics to fight the infection.

You will usually need to take antibiotics for two to six weeks or longer to clear up the infection. Once your fever and the worst of your signs and symptoms have passed, you may be able to leave the hospital and continue IV antibiotic therapy with visits to your doctor’s office or at home with home-based care. You’ll need to see your doctor regularly to make sure your treatment is working.

Sometimes surgery is needed to treat persistent infections or to replace a damaged valve. Surgery is also sometimes needed to treat endocarditis that’s caused by a fungal infection.

Depending on your condition, your doctor may recommend either repairing your damaged valve or replacing it with an artificial valve made of animal tissue or man-made materials.

Lifestyle changes & Home remedies

What are some lifestyle changes or home remedies that can help me manage subacute bacterial endocarditis?

The following lifestyles and home remedies might help you cope with subacute bacterial endocarditis:

  • Practice good oral hygiene every day, which may include:
  • Regular brushing and flossing of the teeth and gums; avoid aggressive brushing of teeth
  • Have regular dental checkups
  • Ensuring that dentures fit properly
  • Avoid any procedure that can potentially lead to skin infections including body piercings and tattoos
  • Ensuring that strict safety and standardized practices are observed during the performance of any diagnostic tests or surgical procedures within a hospital environment
  • Treat any heart-related illness or disease promptly
  • Avoiding the use of intravenous drugs
  • Controlling diabetes through suitable lifestyle changes
  • Immediately addressing any medical issues causing poor immune system, including appropriate treatment of HIV infection and AIDS
  • Frequent follow up physician visits for individuals who have been diagnosed with endocarditis in the past

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: March 19, 2017 | Last Modified: April 23, 2017

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