Prosthetic valve endocarditis

Prosthetic valve endocarditis occurs among individuals with prosthetic heart valves. The condition can be caused by bacteria including staphylococcus or streptococcus or even the aspergillus or candida fungus. In addition, an infection from a different part of the body might enter the bloodstream and attack the heart valves.

The condition can arise at any age but typically affects the elderly. If left untreated, the outcome is undesirable and almost always fatal.

What are the indications?

The manifestation of the signs of prosthetic valve endocarditis is based on whether it is the early or late type.

With the early type, it arises right after the valve replacement surgery while the late type might take several months or even years to arise after the surgery.

The usual signs linked with prosthetic valve endocarditis might include:

  • Low-grade fever with chills
  • Night sweats

    Abdominal issues such as stomach pain and nausea or vomiting.

  • Headache
  • Malaise and fatigue
  • Poor appetite and weight loss
  • Joint pain
  • Chest pain and cough
  • Confusion
  • A new or changing heart murmur
  • Abdominal issues such as stomach pain and nausea or vomiting
  • Electrical irregularities in the heart
  • Stroke
  • Osler’s nodes which are reddened, painful, elevated lesions usually on the distal fingers
  • Intracranial hemorrhage
  • Splinter hemorrhage which are miniature blood clots beneath the fingernails
  • Conjunctival hemorrhage
  • Enlargement of the spleen
  • Spleen and kidney infarcts which are disruptions in the blood supply
  • Glomerulonephritis

Management of prosthetic valve endocarditis

Prosthetic valve endocarditis is a serious form of infection that necessitates prompt medical care. Nevertheless, it can be fully cured if proper treatment is provided.

Bacterial infections

  • Intravenous antibiotics are given. Initially, ceftriaxone or vancomycin is given and later modified based on the laboratory results.
  • In some instances, surgery is needed for persistent infections that do not respond to antibiotic therapy.

Fungal infections

  • Antifungal medications
  • Surgery might be required in some cases

There are cases in which the removal of the prosthetic device responsible for the infection is carried out. In some cases, surgery is also done to remove the infected region in the heart or fix any abnormalities in the heart valve.


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