You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page.
Turn on more accessible mode
Turn off more accessible mode
Skip Ribbon Commands
Skip to main content
Turn off Animations
Turn on Animations
CTDetailNew
It looks like your browser does not have JavaScript enabled. Please turn on JavaScript and try again.
Appointment
Find a Condition or Treatment
Find a Doctor
Menu
MAIN
Back to Home
About Us
Corporate Profile
Newsroom
Events
Procurement
Contact Us
Patient Care
Conditions & Treatments
Specialties & Services
Find a Doctor
Your Clinic Visit
Visitor Information
E-services
Research & Innovation
Research Platforms
Researchers
Laboratories
Clinical Trials & Research
Publications
SingHealth Research
Neurocognitive Research & Clinical Centre (NNRC)
Education & Training
Residency
Health Professional Education
Fellowships
SingHealth Academy
Careers
Why Choose Us
Career Choices
Scholarships & Sponsorships
Job Opportunities
Contact Us
Giving
Why Give
Get Involved
Your Gift at Work
Be Informed
Make a Gift
Conditions & Treatments
Back to Home
Find a Condition
Find a Medicine
Patient Education Brochures
教育手册
Health Apps
Memory Care
Parkinson's Care
Stroke Buddy
Specialties & Services
Back to Home
Clinical Specialties
Neurology
Neurosurgery
Diagnostic Radiology (Neuroradiology)
Neurodiagnostic Laboratory
Neuromuscular Laboratory
Programmes
NNI-Community Health Programme
Temasek Foundation-NNI Stroke Memory Rehabilitation (SMaRT) Programme
淡马锡基金会 - 新加坡国立脑神经医学院中风后记忆康复 (SMaRT) 课程
Temasek Foundation Parkinson's Disease Community Care Programme
Video & Phone Consultation
Drop and Go
PillDeliver
Find a Doctor
Your Clinic Visit
Back to Home
Your Clinic Visit
Getting to NNI
Getting around NNI@TTSH
Make or Change Appointment
Consultation Charges
Billing & Payment
Visitor Information
Back to Home
Advisory: COVID-19 & MERS
Getting to NNI
Neuroscience Clinic (NSOC) at NNI@TTSH
Neuroradiology (NRD) at NNI@TTSH
Neurodiagnostic Laboratory (NDL) at NNI@TTSH
Patient Support Groups
NNI Virtual Tour
Contact Us
E-services
Back to Home
Make/Change/Cancel Appointment
Home
to skip to the main content on a page
to skip to the main content on a page
About Us
Back to Home
Corporate Profile
Our Vision and Mission
Our History
Chief Executive Officer's Office
Our Services
Newsroom
News Release
News Articles
Publications
NeusLink
Events
Procurement
Contact Us
Submit Enquiry, Feedback or Compliment
Check Fake News
Patient Care
Back to Home
Conditions & Treatments
Find a Condition
Find a Medicine
Patient Education Brochures
教育手册
Health Apps
Specialties & Services
Clinical Specialties
Programmes
Video & Phone Consultation
Drop and Go
PillDeliver
Find a Doctor
Your Clinic Visit
Your Clinic Visit
Make or Change Appointment
Consultation Charges
Billing & Payment
Visitor Information
Advisory: COVID-19 & MERS
Getting to NNI
Patient Support Groups
NNI Virtual Tour
Contact Us
E-services
Make/Change/Cancel Appointment
Research & Innovation
Back to Home
Research Platforms
ASEAN Microbiome Nutrition Centre (AMNC)
BioNeuro-Computing
Genomics
Regenerative Medicine
NNI Special Signature Programme
Researchers
Research Director's Message
Laboratories
Calcium Signalling Laboratory
Neural Stem Cell Research Laboratory
Neurodegeneration Laboratory
Neuro-Oncology Research Laboratory
Molecular Neurotherapeutics Laboratory
Parkinson’s Disease & Movement Disorders Translational Research Laboratory
Translational Therapeutics Laboratory
Clinical Trials & Research
Publications
SingHealth Research
Neurocognitive Research & Clinical Centre (NNRC)
Education & Training
Back to Home
Residency
Health Professional Education
Neurology Education
Neurosurgery Education
Neuroradiology Education
Neuroscience Nursing Education
Fellowships
SingHealth Academy
Careers
Back to Home
Why Choose Us
Benefits
Health & Wellness
Appreciation & Recognition
Fun & Recreation
Professional Development
Career Choices
Scholarships & Sponsorships
Job Opportunities
Contact Us
Giving
Back to Home
Why Give
About NNI Fund
Patient Care
Innovative Research
Advanced Medical Education
Get Involved
Make a Gift
Be a Corporate Partner
Join our Events
Past Events
Our Thanks
Your Gift at Work
Meet Grateful Patients
Meet Our Researchers
Meet Staff Donors
Be Informed
Giving Reports
Make a Gift
NNI Fund
Home
>
Patient Care
>
Conditions and Treatment
>
Infective Endocarditis
Facebook
WhatsApp
Email Us
share
Font Resize
A-
A
A+
Print
Infective Endocarditis
Infective Endocarditis: Symptoms, Causes and Risk Factors, Diagnosis, Treatments | National Heart Centre Singapore
Infective Endocarditis - What it is
Infective Endocarditis (IE), also known as bacterial endocarditis (BE), is an infection typically caused by bacteria which enters the bloodstream and remain in the heart lining, blood vessel or heart valve. There are two categories of IE: acute IE and chronic IE. Acute IE is an infection that occurs suddenly and may worsen drastically within days. Meanwhile, chronic IE occurs over a few weeks or months. While it is an uncommon condition, patients with certain heart conditions have a higher risk of developing IE.
Possible Complications of Infective Endocarditis (IE)
Diseased or damaged heart valves
: IE may damage heart valves resulting in abnormal valve function.
Abnormal heart rhythm/Arrhythmia
: IE is one of the many heart conditions that can cause abnormal heart rhythms.
Heart failure
: When valvar function is significantly affected, the heart might be unable to pump sufficient blood around the body.
Stroke
: Infection “clumps” may dislodge and block off the brain’s blood flow, causing a stroke.
Sepsis
: A life-threatening condition where the infection is very severe, resulting in multi-organ failure or even death.
Infective Endocarditis - Symptoms
There are numerous symptoms of infective endocarditis (IE) and these may differ based on the cause of the infection and whether the patient has underlying heart problems. The common symptoms of IE include:
Pain in the joints and muscles
Fever
Chills
Night sweats
Swelling in the legs, feet or abdomen
Breathlessness
Fatigue
Heart murmurs
Rapid heart rate
Persistent cough
However, some patients might experience less common symptoms such as:
Unexplained weight loss
Tenderness near the left ribcage
Flat spots that are red, purple or brown, on the palms or soles of the feet (Janeway lesions)
Painful bumps or patches of darkened skin on the tips of fingers or toes (Osler nodes)
Red, purple or brown spots on the skin, inside the mouth or the whites of the eyes
Infective Endocarditis - How to prevent?
There are a number of ways to prevent or reduce your risk of getting infective endocarditis (IE).
1) Be attentive to signs and symptoms of IE
If you experience any of the common symptoms of IE such as a persistent fever, unexplained tiredness or any wounds that do not heal properly, please see your doctor immediately.
2) Practice good oral hygiene
Brush and floss your teeth regularly and do not let gum disease go untreated.
Dental Hygiene is important to prevent IE; please visit your dentist at least once a year.
3) Care for your wounds
If you have any cuts or grazes that show early signs of an infection, please wash them. If you begin to develop symptoms of a skin infection, please see your doctor immediately. Some of these symptoms include:
Inflammation of the affected area
Sore and warm skin
Discharge of pus or fluid
Fever
Chills and shivering
To avoid this, refrain from cosmetic procedures like piercings or tattoo that involve breaking the skin.
4) Prophylactic (preventive) antibiotics
Prophylaxis (taking preventive antibiotics) against IE is recommended for the following patients with:
Prosthetic cardiac valves, including transcateter implanted prostheses and homografts
Prosthetic material used for cardiac valve repair, such as annuloplasty rings and chords
Previous infective endocarditis
Unrepaired cyanotic congenital heart disease or repaired congenital heart disease, with residual shunts or valvular regurgitation at the site of or adjacent to the site of a prosthetic patch or prosthetic device.
Cardiac transplant with valve regurgitation due to a structurally abnormal valve.
There is no evidence for endocarditis prophylaxis in gastrointestinal or genitourinary procedures unless there is active infection.
Dental procedures for which endocarditis prophylaxis is recommended:
Any dental procedures that involve manipulation of gingival tissue, manipulation of the
periapical region of teeth, or perforation of the oral mucosa in patients.
Infective Endocarditis - Causes and Risk Factors
Infective endocarditis (IE) is caused by germs that enter the bloodstream through a wide variety of ways. Bad oral hygiene, minor injury in the mouth or gums, implanted heart devices, and chronic skin disorders are some of the common ways bacteria enter the bloodstream.
Certain risk factors can increase one’s chances of getting IE, including:
Age
: IE often occurs in older adults, especially those above the age of 60, who make up 25% of all IE patients.
Artificial heart valves
: Artificial or prosthetic heart valves tend to have risks of IE.
Congenital heart defects
: Having certain heart defects from birth such as faulty valves or a hole in the septum can increase one’s risks of having IE.
Damaged heart valves:
Rheumatic fever or other infections can cause scarring to the heart valves, increasing the risk of IE. A history of IE also increases the chances of recurrent infections.
Diabetes mellitus
:
Those with type II diabetes were shown to have higher incidence of IE than patients without.
Gender
: Men are two times more likely to suffer from IE compared to women.
Immunosuppression
: Those with weakened immune systems are more likely to get IE.
Implanted devices
: Bacteria and germs can attach to cardiac devices like
pacemakers
, thus infecting the lining of the heart.
Use of illegal IV drugs
: Those who consume banned drugs via IV needles are at higher risk of developing IE because of contaminated needles and syringes.
Poor oral hygiene or dental health
: Poor oral hygiene increases the chances of bacteria growing inside the mouth and entering the bloodstream through any wounds on your gums. Certain dental procedures may cause injuries to the gums and allow bacteria to enter the bloodstream, leading to IE.
Infective Endocarditis - Diagnosis
Diagnosis of infective endocarditis (IE) normally starts with a physical examination by a doctor, assessing your medical history and conducting routine tests. Other tests recommended may include:
Chest X-ray
:
Helps determine if the infection from IE has spread to the lungs or caused swelling in the heart.
Blood tests
: Demonstrates elevated inflammatory markers such as C-reactive protein. Results from a blood cultures (blood tests taken over time) can help identify germs or bacteria in the bloodstream and thus allow the doctor to prescribe the relevant antibiotics for treatment.
Complete blood count
: A high count of white blood cells indicates infection. A low count of red blood cells can also be a sign of IE.
Echocardiogram
: An ultrasound scan of the heart can show how well the heart, its chambers and its valves are functioning. An echocardiogram is mostly used to check for clumps of bacteria, damage to heart valves or heart tissue. In some cases, a transoesophageal echocardiogram (TEE) might be used to provide clearer images of the heart.
Cardiac Computed Tomography (CT)
: Allows the doctor to check if the infection has spread to any other parts of the body.
Cardiac MRI
:
Usually requested if other modes of imaging are inadequate.
Infective Endocarditis - Treatments
If left untreated, infective endocarditis (IE) can result in life-threatening complications. As such, IE is typically treated with medication or surgical intervention.
Medication
Most people with infective or bacterial endocarditis can be treated with a high dose of antibiotics administered via an IV drip. Blood cultures will continue be taken throughout the patient’s stay in the hospital to monitor his/her symptoms and the treatment progress. When the symptoms have largely gone away, the patient might be discharged. However, the patient will have to continue with the IV antibiotics at home or with their doctor for several weeks.
If IE is caused by a fungal infection, antifungal medication might have to be taken for life to prevent the infection from recurring.
Surgical procedures
Surgical procedures might be required for those with severe IE infections or to replace a damaged heart valve. The key surgical procedures used to treat IE are
valve repair/replacement
, fluid or pus drainage, and repair of any unusual passageways (fistula) that have developed. Generally, surgery will be recommended to patients with the following:
Persistent symptoms like a high fever even with medication
IE due to fungal infections
Prosthetic (artificial) heart valve
Potential
heart failure
due to valve issues
Build-up of pus or fluid
Opening of an unusual passageway (fistula) in the heart
Valve disease or damage
Generally, the benefits of surgical intervention include:
Increased chances of survival
Lower risk of recurrent IE infections
Prolonged symptom relief
Preservation of heart function which can prevent heart failure
Despite the benefits of surgical intervention for those with IE, this may not always be suitable. Those who are older, have chronic conditions or weaker immune systems might be unable to undergo surgery. Please speak with your doctor to discuss your suitability for these surgical procedures.
Infective Endocarditis - Preparing for surgery
Dental Surgeon / Doctor should confirm that the patient would / would not require antibiotic prophylaxis for dental extraction or operation.
Infective Endocarditis - Post-surgery care
Infective Endocarditis - Other Information
Overview
Tags:
Adult Congenital Heart Disease
Article contributed by
Department of Cardiology
,
National Heart Centre Singapore
;
NHCS Cardiology @ SKH
The information provided is not intended as medical advice.
Terms of use
. Information provided by
Our Breast Team
Filter:
By designation or sub-specialty
By Designation:
By Sub-Specialty:
TOP
[]
Related Conditions
Adult Congenital Heart Disease
View more
Related Medicine
Healthy Living Tips
by
View more
Discover articles,videos, and guides afrom Singhealth's resources across the web. These information are collated, making healthy living much easier for everyone.
What to Eat Before, During and After a Marathon
Understanding Chest Pain
Exercises for Cardiac Patients (Sitting)
Exercises for Cardiac Patients (Standing)
My Health Tools
Request/ Change appointment
Find a Specialist
×
SUBCRIBE VIA EMAIL
Subcribe to our mailing list to get the updates to your email inbox...
Find a Doctor
Conditions & Treatments
Home
Appointments
E-services