Here are some additional comments, with a reminder that I’m not an expert on infections or endocarditis; and in addition to members’ valuable personal experiences if a reader wants more information they can always read about endocarditis on credible heart care websites or consult their cardiologist:
I agree that our oral flora is one of the most common sources of endocarditis (e.g., strep viridans). However, we should keep in mind that there are other sources and bacterial types associated with endocarditis. For example, after valve replacement surgery I was given an American Heart Association card that spells out the types of procedures for which they recommend I take pre-meds (antibiotic prophylaxis). These meds are used before particular procedures regarding dental (oral flora), respiratory, gastrointestinal (intestinal flora), and genitourinary (e.g., urinary tract). Also noteworthy are other types of bacteria that can cause endocarditis, including
Staphylococcus aureus and
Enterococcus to name a few. Staphylococcus aureus is a particularly virulent bacteria, and can lead to an aggressive form of endocarditis (acute).
I believe some sources of endocarditis can emanate from outside of our bodies, that manage to infiltrate, although I don’t know how prevalent this origin is compared to others. It’s noteworthy that a variety of staph bacteria can live on our skin. Intravenous drug users are vulnerable to S. aureus infections and thus have a higher incidence of endocarditis. They tend to share unsanitary needles, injecting straight into a vein, and leaving numerous deep puncture wounds on their skin inviting infection.
Is it technically possible that a common puncture wound can get infected with the right type of bacteria that is known to be associated with endocarditis?, I think so (remember I’m no expert
), but we aren’t dropping off like flies! However, I believe it’s always good to clean a wound and monitor it for infection, and know the symptoms to play it safe. I don’t think that all local infections would necessarily lead to a systemic infection or contain the endocarditis causing culprits (but would we know what entered?), however as a person with a prosthetic valve it seems best to understand the potential issues, and I personally tend to error on safety when it comes to an infection. But I also remind myself that endocarditis is of relatively low occurrence, we have natural immune system barriers that help protect us, and I take prudent precautions and my pre-meds before dental procedures. Even though I survived endocarditis once before, I don’t worry about it too much, no use being paranoid, and still lots of living to do. Unfortunately, it seems much of the time it’s the luck/unluck of the draw whether you contract it, but it’s a serious issue for us heart valve patients, not to be taken lightly, and so a certain amount of precaution and knowledge is a good thing :thumbup:.
