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 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, if you have structural heart conditions or damage, you may have a rough area on the heart lining. These rough areas inside the heart invite bacteria to build up and multiply.

How does the bacteria get inside the body?

Bacteria can enter the body in many ways. 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?

People with congenital heart disease may be at increased risk of developing an infection inside the heart. Congenital conditions are those where the structure of the heart developed abnormally in the womb. They have therefore been present since birth. These conditions can sometimes cause turbulent blood flow through heart chambers, as can areas or 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 healthcare 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 transplant with heart valve disease

Consult your child's healthcare 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 exam of your child, other tests 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 can't 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 child's healthcare providers.

Treatment for bacterial endocarditis

Your child's healthcare 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 healthcare provider for more information.