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 vavle), 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

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