What is infective endocarditis?Infective endocarditis is an infection of the lining of the heart (endocardium), but it can also affect the heart valves and the muscle of the heart.
There are two forms of the condition: acute infective endocarditis which develops suddenly and can be life threatening within days; and a second form called subacute infective endocarditis or subacute bacterial endocarditis, which develops gradually over a number of weeks or months.
Infective endocarditis infects twice as many men as it does women, with 25 per cent of cases occurring in those older than 60 years.
My eight-year-old nephew has been diagnosed with the subacute form of it. Could it have anything to do with a heart valve problem he was born with?
Yes, there is an increased risk of developing infective endocarditis if you have a cardiac birth defect, such as abnormal or damaged valves. Bacteria which make their way into the bloodstream can lodge in these damaged heart valves.
Other risk factors include previous damage to the heart as a result of rheumatic fever and in older people, calcium deposits in the mitral valve or in the aortic valve may predispose them to endocarditis.
Those who use injected illicit drugs are at risk of the disease due to the fact that they may inject bacteria straight into the bloodstream through infected needles, equipment or solutions. And for people who have had a heart valve replaced, there is a higher risk of contracting the condition compared to that of the general population.
Can it be treated with medication alone?
Treatment of endocarditis usually involves intravenous antibiotics given at high doses for up to several weeks. However, antibiotics alone may not eradicate the infection and surgery will therefore be required to replace or repair the faulty valve. If left untreated, the condition can be fatal.
In terms of prevention, those known to have an existing valve problem are often given antibiotics for certain dental, surgical and medical procedures. Although the risk of developing endocarditis as a result of a routine procedure is relatively low, and preventive treatment with antibiotics not always effective, many doctors believe it is best to give antibiotics in these instances as a reasonable precaution.