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Subacute endocarditis usually develops gradually and subtly over a period of weeks to several months. Something as minor as a small cut can enable bacteria that normally live on the skin to get into the bloodstream. These general, nonspecific, symptoms can make it hard both for the patient and the doctor to recognize endocarditis. As infection progresses, other symptoms may develop. Subacute bacterial endocarditis (SBE) has an insidious onset and may have some or all of all of the following symptoms:- Intermittent low-grade fever, chills and excessive sweating, especially at night
- Fatigue and weakness
- Vague aches and joint pains. Back pain, may be severe
- Heart murmur
- Weight loss
- Late stages:
- Severe chills and high fever
- Shortness of breath on exertion
- Swelling of the feet, legs and abdomen
- Rapid or irregular heartbeat
In some 5 to 10% of cases, fungal infection or some rare bacteria may be the cause of endocarditis and in this group the blood cultures are negative.
Treatment & Prevention
The goal of treatment is to eradicate the infecting organism with medications and supportive care for relieving symptoms, with hospital care during the acute phase. It is always fatal if untreated. Possible complications include: Infected blood clots that may travel to the brain, kidneys, or abdominal organs causing infections, abscesses or stroke; heart-rhythm disturbances (atrial fibrillation is most common); destruction of heart valves; lung clots; arthritis; myositis (inflammation of muscles); acute renal failure.
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