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Endocarditis (cont.)



Most people with endocarditis have symptoms that begin within 2 weeks after becoming infected. Vague, flu-like symptoms, such as a low-grade fever and fatigue, often occur first. But infection with a powerful strain of bacteria may cause symptoms to be more severe (such as a high fever) and to appear much faster, within a few days. If symptoms persist, see your doctor, especially if you are at a high risk for endocarditis.

Symptoms include:

  • Chills and fever.
  • Fatigue.
  • Weight loss.
  • Night sweats.
  • Painful joints.
  • Persistent cough and shortness of breath.
  • Bleeding under the fingernails.
  • Tiny purple and red spots under the skin.


You will likely have symptoms if you have a complication of endocarditis. Complications may include:

Exams and Tests

The first step in diagnosing endocarditis is a review of your medical history and a physical exam.

As part of your medical history, your doctor will ask you:

  • About your symptoms.
  • If you have a heart murmur or have had valve replacement surgery.
  • If you have any recent risk factors (things that put you at risk) for a bacterial or fungal infection, such as drug injection, dental procedures, or a catheter (such as a catheter for hemodialysis).

As part of your physical exam, your doctor will check your body for signs of an infection. This includes:

  • Looking in your eyes for small amounts of bleeding.
  • Looking at your skin for tiny purple or red spots, tender bumps, or painless red spots.
  • Listening to your heart for a murmur.
  • Listening to your lungs for any fluid buildup.
  • Giving you a neurologic exam to check for signs of a stroke.

Other tests may be needed to diagnose endocarditis. They include:

  • Blood cultures. Several blood cultures are recommended to identify bacteria or fungi in the bloodstream. But sometimes blood cultures fail to detect endocarditis. The cultures may fail because you recently took antibiotics or the bacteria or fungi causing your endocarditis do not grow well in a lab culture. If the blood cultures do not detect endocarditis, you may need further testing.
  • Echocardiogram, including transthoracic echocardiogram (TTE) and transesophageal echocardiogram (TEE). These tests use high-pitched sound waves to produce an image of the heart. They can find infected areas, heart valve defects, and other abnormalities.

You may need other tests to identify complications of endocarditis. These tests may include:


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