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Bacterial Endocarditis


Bacterial endocarditis is an infection of the heart valves or inner lining of the heart, called the endocardium. Bacteria in the mouth, intestinal tract or urinary tract travel to the heart via the bloodstream and can cause growths or holes in the valves or tissue, seriously damaging the heart.

This bacteria generally don't cause problems but can be life threatening in patients with heart disease or valve conditions.

Our approach to bacterial endocarditis

UCSF's cardiac specialists are highly trained in preventing, diagnosing and treating bacterial endocarditis. We evaluate patients for this infection of the heart linings using blood tests, imaging and electrocardiography. After diagnosis, we treat the infection with intravenous antibiotics. Surgery may be required in cases where the infection has damaged the heart, and our surgical team offers these patients the full range of minimally invasive techniques.

People born with heart defects are at a higher risk of developing endocarditis. Our congenital heart disease program provides these patients with exceptional, ongoing care aimed at lessening the chance of infection, detecting signs early and responding with a treatment plan tailored to individual needs.

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Signs & symptoms

Bacterial endocarditis is most likely to occur in patients who have the following conditions:

Patients who have successful surgical repair of these heart conditions can greatly reduce their risk of developing bacterial endocarditis.

A common sign of bacterial endocarditis is prolonged fever for two to three days in patients with congenital heart disease, particularly after a dental, intestinal or urinary tract procedure.

Symptoms also may include:

  • Poor appetite
  • Fatigue
  • Joint pain
  • Rash
  • Weight loss


A blood test is the primary test for bacterial endocarditis. Three to five blood samples may be taken in a 24-hour period to determine the presence of the bacteria.

A urine sample also may indicate the presence of infection but is not adequate by itself for the diagnosis.

An echocardiogram may detect an abnormality, such as a mass on a heart valve or on the heart wall surface, called a vegetation.


Bacterial endocarditis usually can be prevented by taking antibiotics immediately before and after procedures in which bacteria may be released into the bloodstream, such as:

  • Bronchoscopy
  • Dental cleaning
  • Gallbladder or prostate surgery
  • Some surgeries in the respiratory passageways, or the gastrointestinal or urinary tracts
  • Tonsillectomy and adenoidectomy

People at risk for bacterial endocarditis are encouraged to practice good oral hygiene.

Once endocarditis is diagnosed, treatment usually consists of intravenous antibiotics. Recovery may take four to six weeks and there is a risk of permanent heart damage.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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