Introduction:

Subacute bacterial endocarditis (SBE) is a rare but serious infection that affects the inner lining of the heart and its valves. It is typically caused by bacteria entering the bloodstream and lodging in the heart's lining or valves. This comprehensive article aims to provide a thorough understanding of SBE, including its causes, symptoms, diagnosis, treatment, and prevention.

Causes of Subacute Bacterial Endocarditis:

SBE is primarily caused by bacteria, most commonly the viridans group streptococci. The bacteria enter the bloodstream through various means, including dental procedures, infections, or intravenous drug use. Individuals with pre-existing heart conditions or damaged heart valves are at higher risk of developing SBE.

Symptoms of Subacute Bacterial Endocarditis:

SBE presents with a range of symptoms that may develop gradually and include:

• Fever: A persistent, low-grade fever is a common early symptom of SBE.
• Fatigue: Profound tiredness and weakness are often reported.
• Heart murmur: An abnormal heart sound, known as a heart murmur, may be detected during a physical examination.
• Joint pain: Pain and swelling in the joints can occur.
• Shortness of breath: Individuals may experience difficulty breathing, especially during physical activity.
• Skin changes: Small, painless red or purple spots on the skin, known as petechiae, may appear.
• Weight loss: Unintended weight loss can be a symptom of SBE.

Diagnosis of Subacute Bacterial Endocarditis:

Diagnosing SBE typically involves:

• Blood cultures: Multiple blood samples are collected to identify the specific bacteria causing the infection.
• Echocardiography: An echocardiogram uses sound waves to create images of the heart, allowing healthcare providers to assess any damage to the heart valves.
• Physical examination: A thorough physical exam helps detect symptoms such as heart murmurs and skin changes.

Treatment of Subacute Bacterial Endocarditis:

Treatment of SBE typically includes:

• Antibiotics: High-dose intravenous antibiotics are administered for an extended period, often several weeks. The choice of antibiotics depends on the type of bacteria causing the infection.
• Surgery: In severe cases, surgical intervention may be necessary to repair or replace damaged heart valves.

Prevention of Subacute Bacterial Endocarditis:

Preventing SBE involves:

• Good dental hygiene: Proper dental care, including regular check-ups and treatment of dental infections, can reduce the risk of bacteria entering the bloodstream during dental procedures.
• Prophylactic antibiotics: Individuals with certain heart conditions may be prescribed antibiotics before dental or surgical procedures to prevent SBE.
• Intravenous drug use precautions: Safe injection practices and avoiding shared needles can reduce the risk of SBE in individuals who use intravenous drugs.

Conclusion:

Subacute bacterial endocarditis is a serious infection of the heart's lining and valves, primarily caused by bacteria entering the bloodstream. By understanding its causes, symptoms, diagnosis, treatment, and prevention measures, individuals can take steps to reduce the risk and ensure early intervention if SBE is suspected.

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