How is bacterial endocarditis diagnosed?

The diagnosis of bacterial endocarditis is based on the presence of symptoms, the results of a physical examination and the results of diagnostic tests:

  • Symptoms of infection (see list above), particularly a fever over 100°F (38.4°C)
  • Blood cultures show bacteria or microorganisms commonly found with endocarditis. Blood cultures are blood tests taken over time that allow the laboratory to isolate the specific bacteria that is causing your infection. Blood cultures must be taken before antibiotics are started to secure the diagnosis.
  • Echocardiogram (ultrasound of the heart) may show growths (vegetations on the valve), abscesses (holes), new regurgitation (leaking) or stenosis (narrowing), or an artificial heart valve that has begun to pull away from the heart tissue. Sometimes doctors insert an ultrasound probe into the esophagus or “food pipe” (transesophageal echo) to obtain a closer more detailed look at the heart.
  • Other signs and symptoms of bacterial endocarditis include:
    • Emboli (small blood clots), hemorrhages (internal bleeding), or stroke
    • Shortness of breath
    • Night sweats
    • Poor appetite or weight loss
    • Muscle and joint ache

Last reviewed by a Cleveland Clinic medical professional on 04/29/2019.

References

  • Nishimura, RA, et. al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart DiseaseA Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129 (23) e521-e643. https://www.ahajournals.org/doi/full/10.1161/cir.0000000000000031 Accessed 12/2018
  • Nishimura, RA, et. al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017; 135 (25) e1159-e1195. https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000503 Accessed 12/2018
  • Habib G, et. al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009) The Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). European Heart Journal (2009) 30, 2369–2413 doi:10.1093/eurheartj/ehp285 http://eurheartj.oxfordjournals.org/content/ehj/30/19/2369.full.pdf Accessed 12/2018
  • Wilson W, et. al. Prevention of Infective Endocarditis Guidelines From the American Heart Association A Guideline From the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007;116:1736-1754 http://circ.ahajournals.org/content/116/15/1736.full.pdf Accessed 12/2018

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy