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Subacute bacterial endocarditis is a bacterial colonization of a diseased area inside the heart. The bacteria can settle anywhere along the endocardium, the tissue lining the heart, and often show up around the heart valves. This condition can be fatal if a doctor does not provide treatment. Treatment usually involves high doses of intravenous antibiotics to kill the bacteria off quickly and clear the infection. Patients with a history of subacute bacterial endocarditis may need to take prophylactic antibiotics before certain medical procedures to prevent a recurrence.
This condition occurs when a patient has existing heart valve or cardiac defects. The conditions inside the heart make it vulnerable to colonization by bacteria normally found in the body. Early symptoms are often subtle. The patient can experience chills, weight loss, fever, and fatigue. Changes to the heart can be seen on medical imaging studies, and as the infection progresses, patients can develop congestive heart failure.
When a doctor evaluates a patient with a suspected case of subacute bacterial endocarditis, patient history is important. A person with a history of heart disease or drug use is more likely to have the cardiac damage associated with this condition. The doctor can listen to the heart, use medical imaging to get a picture of what is going on inside the chest, and may also perform bloodwork and request an electrocardiogram study of the heart for the purpose of determining the current level of heart function.
The doctor will prescribe intravenous antibiotics in large doses, with a treatment schedule depending on the antibiotic and the patient. Patients can experience side effects like nausea and vomiting as a result of the antibiotics, but should experience an improvement in the subacute bacterial endocarditis. If complications like congestive heart failure develop, additional supportive therapies may be needed to stabilize the patient while the antibiotics have time to work.
This contrasts with acute bacterial endocarditis, where bacteria colonize a healthy heart. Subacute bacterial endocarditis tends to progress more slowly, although this is not always the case, and it usually involves a patient with a prior history of heart disease. Sometimes, this condition can be seen in intravenous drug users or patients with infections acquired in a hospital setting. Whether acute or subacute, infections of the endocardium require rapid and aggressive treatment to prevent complications, including potentially fatal heart disease. A cardiologist may supervise care for the patient during treatment and recovery.