Does getting endocarditis post-valve surgery always mean surgery is needed to replace the valve? Will IV antibiotics not do the trick?
Endocarditis
- Thread starter Luana
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It depends how quickly they catch it and if there is any damage. Justin had BE and didn't need surgery
We must pay attention.
We must pay attention.
Luana, I've worked with my family Doctor for ten years now and have come to trust her as a physician and friend. She has been very up front about this topic. Her request is that I report every infection or illness promptly so that she can evaluate it at once. In the past 6 weeks, I've had two for some reason at which point she ordered cultures and immediately began a round of antibiotics. In one case, she changed the antibiotic when the culture results were returned. She thinks that by taking this approach, infections are not likely to grow to a point where BE can develop and threaten my valve or valve site.
My Doctor says that it is unlikely that many infections will harm my valve or valve site but that by dealing with each of them more agressively one can dramatically reduce the threat of BE. This does require the we participate by being more vigilant about our health and accepting the wisdom of promptly reporting problems when we realize something is wrong. Take care.
Larry
We must pay attention.
Luana, I've worked with my family Doctor for ten years now and have come to trust her as a physician and friend. She has been very up front about this topic. Her request is that I report every infection or illness promptly so that she can evaluate it at once. In the past 6 weeks, I've had two for some reason at which point she ordered cultures and immediately began a round of antibiotics. In one case, she changed the antibiotic when the culture results were returned. She thinks that by taking this approach, infections are not likely to grow to a point where BE can develop and threaten my valve or valve site.
My Doctor says that it is unlikely that many infections will harm my valve or valve site but that by dealing with each of them more agressively one can dramatically reduce the threat of BE. This does require the we participate by being more vigilant about our health and accepting the wisdom of promptly reporting problems when we realize something is wrong. Take care.
Larry
Larry,
I totally agree. I had BE years ago before VR and was misdiagnosed several times and it was 3 months of running a fever every day before a doctor took me seriously about having BE. I don't want to get it again, and don't let anything go unattended.
Lynn, I kind of thought that's how it is, but have read here a lot of those with replaced valves having surgery, so wasn't sure if that was always the case.
Seems that doctors are more vigilant about BE now than they were years ago. I had blood cultures done in the hospital when I had a fever and probably a few more times since I've been discharged. Every time I've said the word fever to my cardiologist, he's ordered cultures, which is fine with me. Had I known about blood cultures years ago when I was sick, I would have asked for them, but no one, despite my history of rheumatic fever and a murmur, and that I mentioned BE to the doctors I saw, no one seemed to think it was a problem.
I totally agree. I had BE years ago before VR and was misdiagnosed several times and it was 3 months of running a fever every day before a doctor took me seriously about having BE. I don't want to get it again, and don't let anything go unattended.
Lynn, I kind of thought that's how it is, but have read here a lot of those with replaced valves having surgery, so wasn't sure if that was always the case.
Seems that doctors are more vigilant about BE now than they were years ago. I had blood cultures done in the hospital when I had a fever and probably a few more times since I've been discharged. Every time I've said the word fever to my cardiologist, he's ordered cultures, which is fine with me. Had I known about blood cultures years ago when I was sick, I would have asked for them, but no one, despite my history of rheumatic fever and a murmur, and that I mentioned BE to the doctors I saw, no one seemed to think it was a problem.
Larry, what all would be included as illnesses that should be reported? Even something as simple as a common cold? Or are you only talking about things like cuts that start to get infected? Are there other things to watch out for? I don't have any symptoms or anything, but would like to store away in the back of my mind some things to watch for.
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Gail in Ca
Well-known member
I was diagnosed and started on 3 antibiotics(1 oral, 2 IV) only a week after my flu-like symptoms and 102 fever. In that week, the ER thought I had the flu and sent me away, my own urgent care took my word for it when I said that the ER I went to thought it was the flu. I went in only because I felt so bad and my shoulder was so painful, I felt it couldn't just be rotator cuff strain as the Dr thought that same week. So, 4 days after my initial symptoms, I had blood in my urine, my inr was 6.6. I chalked it up to the flu and so told the urgent care doc that I'd stop my coumadin and test again in 2 days. The next night I had a terrible headache.
And 2 days later my inr was 9.3, and then the urgent care doc ordered ct scan, blood cultures and then sent me to the ER when they found a brain bleed. So, that day, it was thought I had some type of arteritis going on. But, thankfully, it only takes a day to get results from the culture and I had BE from a nasty strain of staph. The whole 6 wks of treatment with antibiotics, left me with severe anemia. But no vegetation had shown up on my TEE's. After only 2 wks off the antibiotics I had shortness of breath while walking uphill. My cardio ordered more tests and it was determined that the ring around my AV was damaged, my old graft had pockets of damage, and my MV leaflets ended up having small holes eaten in them from the bacteria! ( this was discovered during surgery). The staph was resistent to the 1st round of antibiotics, but when penicillin was added, it began to work. Was the damage done that 1st week, or in the first 2 wks of treatment? Don't know.
My friend's husband is a cardio in LA, and he always recommends valve replacement for his patients that have had BE. I do know my cardio thought I had beat it and wouldn't need any surgery, but, alas, he was wrong!
My cardio gave me his personal cell #, to call him if I ever have a fever again.
And 2 days later my inr was 9.3, and then the urgent care doc ordered ct scan, blood cultures and then sent me to the ER when they found a brain bleed. So, that day, it was thought I had some type of arteritis going on. But, thankfully, it only takes a day to get results from the culture and I had BE from a nasty strain of staph. The whole 6 wks of treatment with antibiotics, left me with severe anemia. But no vegetation had shown up on my TEE's. After only 2 wks off the antibiotics I had shortness of breath while walking uphill. My cardio ordered more tests and it was determined that the ring around my AV was damaged, my old graft had pockets of damage, and my MV leaflets ended up having small holes eaten in them from the bacteria! ( this was discovered during surgery). The staph was resistent to the 1st round of antibiotics, but when penicillin was added, it began to work. Was the damage done that 1st week, or in the first 2 wks of treatment? Don't know.
My friend's husband is a cardio in LA, and he always recommends valve replacement for his patients that have had BE. I do know my cardio thought I had beat it and wouldn't need any surgery, but, alas, he was wrong!
My cardio gave me his personal cell #, to call him if I ever have a fever again.
Andy, anytime you have anything with a fever, be careful. You'll have a fever with the flu, but if you're not rid of it after about a week, I'd either get seen or call doc for an Rx for antibiotics. A cold is usually not a problem, but if something lingers, get seen, if you have bronchitis or pneumonia, you should be on antibiotics. It's a good idea to get a yearly flu shot because if you don't get the flu, you most likely won't get something that can be a consequence of it.
Strep throat -- run, don't walk to the nearest ER or Urgent Care if you think you have strep throat.
When I was 22 I had mono, and because of my history my doctor put me in the hospital thinking I had endocarditis. Fortunately, I didn't but the docs did put the fear of God in me by saying if I ever had the flu and couldn't seem to get rid of it, or if you're ever running a fever and nothing else seems to be going on, get in to see a doc ASAP.
Cuts are usually not a problem, thought BE can be caused by strep or staph which we all have on our skin. I usually make sure to wash any cuts or scratches I get and/or swab with hydrogen peroxide. There is a higher risk of BE for a period of time (3 months?) after VR surgery because of the invasive process and because you have wounds that are healing and your defenses are not quite up to par, which is why you need to be careful of infection in incision and chest tube wounds. After those are healed, you're not as likely to be attacked via skin.
Probably you'll never get it, and you do need to be careful that you don't get it. You don't want it. Before antibiotics, if you got endocarditis you died. That was it.
Strep throat -- run, don't walk to the nearest ER or Urgent Care if you think you have strep throat.
When I was 22 I had mono, and because of my history my doctor put me in the hospital thinking I had endocarditis. Fortunately, I didn't but the docs did put the fear of God in me by saying if I ever had the flu and couldn't seem to get rid of it, or if you're ever running a fever and nothing else seems to be going on, get in to see a doc ASAP.
Cuts are usually not a problem, thought BE can be caused by strep or staph which we all have on our skin. I usually make sure to wash any cuts or scratches I get and/or swab with hydrogen peroxide. There is a higher risk of BE for a period of time (3 months?) after VR surgery because of the invasive process and because you have wounds that are healing and your defenses are not quite up to par, which is why you need to be careful of infection in incision and chest tube wounds. After those are healed, you're not as likely to be attacked via skin.
Probably you'll never get it, and you do need to be careful that you don't get it. You don't want it. Before antibiotics, if you got endocarditis you died. That was it.
Infections are something to keep right on top of, quickly addressing. There are many members here who have dealt with BE.
I recall reading something about shivers also. For me, that's usually an indication that whatever bug I may have gotten has crossed the point into being infected.
I also am much quicker about addressing sinus infections too; ignored for even a brief time, they can quickly develop into something much worse.
I recall reading something about shivers also. For me, that's usually an indication that whatever bug I may have gotten has crossed the point into being infected.
I also am much quicker about addressing sinus infections too; ignored for even a brief time, they can quickly develop into something much worse.
Gosh, Lily, I almost totally forgot that, and I'm glad you mentioned shivers. I was freezing most of the time when I was sick. I had a big bulky handmade sweater I got in Greece that I would wear at work and at home when I had the chills. When I was at work, I'd usually start popping aspirin to bring the fever down (finally, I could take the sweater off for a while), and then drink black coffee when I was cold. Yeah, great combination, huh? I must have a stomach like Bina's goats. :wink2:
Justin also had fevers and chills then sweat(usually at night) when he had his BE and then he would feel fine for a while, we took him to the doc a few times before the did bloodwork, because he'd be sick 1 day and pretty good the next. It was weird, sometimes he seemed like he had a respirtory infection, then a few days later a stomach bug, his doctors thought since he was so run down he was just cathcing everything going around school (he was 11) part of the problem was he kept seeing a different ped in the group each time and they would make a diagnosis based on his symptoms that day. So I finally said this is not a much of different things, I think he has been sick all along and when he had an antibiotic it would help for a while then come back. I had to ask for blood work. We had a new pediatrician before he was discharged from the hospital, because I would never trust them again.
There are 2 kinds of BE Acute and sub acute. Acute usually hits hard and fast and does alot of damage quickly. I think usually the people that need their valves replaced right away have Acute. Sub acute can be taken care of with just the antibiotics even if it takes a while to be diagnosed because it is slower acting and can take a while to cause damage to the valves
There are 2 kinds of BE Acute and sub acute. Acute usually hits hard and fast and does alot of damage quickly. I think usually the people that need their valves replaced right away have Acute. Sub acute can be taken care of with just the antibiotics even if it takes a while to be diagnosed because it is slower acting and can take a while to cause damage to the valves
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Yes, and I had SBE, which is why I guess I smoldered for 3 months without buying the farm. I guess there's a few things I forgot about when I had it. When I had the first echo in the hospital, the tech said she didn't see any vegetation on any of the valves (which, of course, she wasn't supposed to tell me), but this is what started my whole learning process about heart stuff.
Anyway, I think everyone post VR surgery should get a mini-course in endocarditis 101. No one had to tell me what to look out for or be careful of, and I hope you post-surgery folks who may never have even heard of BE before, have at least been given some info on it. Oh, I guess that's what this forum is for.
:thumbup:
Gail in Ca
Well-known member
I've read that antibiotics should not be given if BE is suspected until after the blood cultures have come back. They want to know what is causing it, and antibiotic use could muddy the waters. Even after they know what bacteria it is, they often use trial and error, and may have to change up the drugs to get the combo that kills the bacteria. It is scary stuff. Now, when I cut myself, I immediately wash. I use antibacterial gel more often,
and if I step on a rock with bare feet, my 1st thought is, I hope it doesn't give me BE. Going thru that again would be the worst. Yeah, even more so than OHS.
and if I step on a rock with bare feet, my 1st thought is, I hope it doesn't give me BE. Going thru that again would be the worst. Yeah, even more so than OHS.
You read right, if you take Antibiotics before they draw the blood culture (or do the testing on any wound or body fluid for bacteria) the Antibiotics can affect the test results. Usually it is OK to start Broad spectrum Antibiotics AFTER the first set of blood cultures are drawn before they identify what the bacteria is, since it could take a few days (24-48 hours) for the bacteria to grow and do the testing to identify it. Some times the reason they may have to change the Antibiotics, even after they know what the bacteria is, is they probably will start out with one or more antibiotics that SHOULD kill that strain of bacteria. But then have to wait for the bacteria to grow in the lab and test it to see what antibiotics it can grow on and which Antibiotic kill it. That takes a few more days.
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GREAT info guys! Exactly what I was looking for. And I'm not sure if I would have given some of those things a second thought, but will now! I've also got a question about dental work, but I'll post that as a separate thread.
Andy, these ladies have answered you better than I can since they have had much more experience. What my family Doctor said is that the problem you must try to avoid is allowing systemic infections to develop beyond their initial phase. Small surface cuts and scrapes are usually not a problem but should be kept clean and watched to insure they are healing properly. One exception is what you have no doubt already been told which is that you must take antibiotics before having any dental work including cleaning. Several bacteria that can be harmful to the heart (especially to the surgical site and tissue valves) are typically resident in the mouth.
It would be helpful, if I could clone Dr Madaj and send a copy to each of you. She listens to me and if I ask a question will take the time to find me a meaningful answer if there is one. When I call to report a problem, she acts promptly. After my last echo-cardiogram, it was she who told me more about the results than did my Cardio who pretty much just said "it looks good". This kind of relationship is truly invaluable.
Larry
It would be helpful, if I could clone Dr Madaj and send a copy to each of you. She listens to me and if I ask a question will take the time to find me a meaningful answer if there is one. When I call to report a problem, she acts promptly. After my last echo-cardiogram, it was she who told me more about the results than did my Cardio who pretty much just said "it looks good". This kind of relationship is truly invaluable.
Larry
Dumb questions - I looked on Ross's list but did not find BE. What is BE?
It is NOT just Tissue valves. BE can damage ANY kind of valve, either the valves you are born with or replaced valves. (for example Gail in this thread had a mechanical valve that needed replaced because of the damage from BE)
IF anyone is interested, This article is about surgical treatment AORTIC valve BE , but I think it gives alot of good info about BE, the symptons ect and isn't very long and pretty easy to read http://cardiacsurgery.ctsnetbooks.org/cgi/content/full/3/2008/949?ck=nck
Sorry, Pat. BE is bacterial endocarditis which is an infection on your heart valves. It occurs mostly in people who either have a damaged valve due to previous disease, such as rheumatic fever, or those who have had a valve replacement and/or repair. It's almost non-existent among "normal" people with the exception of IV drug users who share needles. It is a life-threatening illness.
Here's a link listing symptoms: http://www.webmd.com/heart-disease/tc/endocarditis-symptoms
I think it's been mentioned but, among other things, all replaced "artificial heart valves" are at risk.
I think it's been mentioned but, among other things, all replaced "artificial heart valves" are at risk.
daveguy14
Well-known member
And it's important to note that "artificial" means "any valve that's not your own," not just mechanical, but tissue too.
