Diagnosing Infectious Endocarditis: Essential Tests and Procedures

Infectious endocarditis is a relatively common condition encountered in clinical settings. However, due to limited experience in some lower-level hospitals, accurately identifying the cause can be challenging. The initial symptom often presented by patients is fever. When fever is detected, the first step is to conduct tests related to infection in order to identify its underlying cause.

Initial Blood Tests to Confirm Infection

One of the primary steps in diagnosing infectious endocarditis involves performing blood tests to detect signs of inflammation and infection. These tests may include a complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and procalcitonin (PCT) levels. These markers help confirm the presence of an infection and assess its severity.

Blood Cultures: Identifying the Causative Pathogen

Blood cultures are crucial in diagnosing infectious endocarditis. Multiple blood samples are drawn from different sites and incubated to detect the presence of bacteria or fungi in the bloodstream. Identifying the specific pathogen is essential for determining the most effective antibiotic treatment.

Imaging Studies to Detect Infection Spread

In addition to blood tests, imaging studies may be performed to check for signs of infection in other organs. A chest X-ray or computed tomography (CT) scan of the chest may be ordered to look for complications such as lung abscesses or septic emboli, which can occur in patients with infectious endocarditis.

Echocardiography: Assessing the Heart

One of the most important diagnostic tools in evaluating infectious endocarditis is echocardiography. This imaging test allows doctors to visualize the heart valves and detect vegetations—clumps of bacteria and cells—that are characteristic of the disease. Two types of echocardiograms are commonly used:

Transthoracic Echocardiogram (TTE)

This non-invasive test uses sound waves to create images of the heart through the chest wall. It is often the first imaging test performed when endocarditis is suspected.

Transesophageal Echocardiogram (TEE)

If the TTE results are inconclusive, a TEE may be performed. In this procedure, a small ultrasound probe is inserted into the esophagus, providing clearer images of the heart valves. This test is more sensitive and is particularly useful in detecting small vegetations or abscesses.

Early diagnosis and prompt treatment are essential in managing infectious endocarditis. If you or someone you know is experiencing unexplained fever, especially with a history of heart disease or recent invasive procedures, it is important to seek medical attention and undergo the appropriate diagnostic evaluations.