Endocarditis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Endocarditis?
An infectious disease doctor, a doctor who treats infections, and a cardiologist, a heart doctor, usually treat endocarditis. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is endocarditis?
Endocarditis is swelling and irritation, called inflammation, of the inside lining of the heart chambers and heart valves. It is most often caused by a bacterial infection. A fungal infection is a rare cause. It is a rare but life-threatening disease.
Clumps of bacteria or fungi from another part of the body get into the blood and collect on the heart lining, more often on the valves. Pieces of the clumps can break off and travel to other parts of the body. They can block blood flow or spread the infection.
Symptoms
Symptoms may develop slowly or start suddenly. They can range from mild to severe. Common ones include:
- Fever, chills, and sweating.
- Fatigue, weakness, and weight loss.
- Muscle and joint aches.
- Shortness of breath.
- Chest pain.
- Blood in the urine.
- A heart murmur, an unusual whooshing sound heard by the doctor.
Fever and chills can be present for days before other symptoms appear. Doctors may also see small areas of bleeding under the nails, red painless spots on the palms and soles, and painful red lumps in the pads of the fingers and toes.
Causes and who gets it
Endocarditis starts when germs enter the bloodstream and travel to the heart. Bacteria are the most common cause. Fungi such as Candida can also cause it. In some cases, no cause can be found.
Germs can enter the blood from gum infections, urinary tract infections, or surgery. Germs can also enter the blood after recent dental surgery, through a central venous line (a long-term tube placed in a large vein), or injecting drugs with unclean needles.
Some people have a higher risk. These include people with:
- A heart defect present from birth.
- A damaged or abnormal heart valve.
- A new heart valve after surgery.
- A past history of endocarditis.
- A weakened immune system.
Men are affected twice as often as women. Older adults have a higher risk than younger adults.
How doctors diagnose it
The doctor asks about your symptoms and health history and listens to your heart. A new heart murmur, or a change in an old one, is a clue. Often, diagnosis is based on fever and a heart murmur along with medical history. Tests may include:
- A blood culture, which finds the bacteria or fungus causing the infection.
- Other blood tests, such as a complete blood count and tests of inflammation.
- An echocardiogram, an ultrasound that looks at the heart valves.
Heart imaging, such as a cardiac MRI, can also help.
Treatment
You may need to be in the hospital to get antibiotics through a vein. Blood cultures help your provider choose the best antibiotic. Antibiotics treat bacterial infections. Antifungal medicines treat fungal infections.
You will then need long-term antibiotic treatment. People most often need it for 4 to 6 weeks to kill all the bacteria from the heart chambers and valves. Treatment started in the hospital will need to be continued at home. Side effects of antibiotics depend on the medicine. They can include diarrhea, hearing, balance, or kidney problems, or a lower white blood cell count.
Surgery to replace the heart valve is often needed when the infection breaks off in pieces and causes strokes or blocked arteries. It is also needed when damaged valves lead to heart failure, or when there is more severe organ damage. Doctors also treat or remove the source of the bacteria, such as an infected pacemaker. Getting treatment right away improves the chances of a good outcome.
When to see a doctor
Contact your provider if you have a fever that does not go away, blood in the urine, tiredness, or weight loss without a change in diet, during or after treatment. Getting treatment for endocarditis right away improves the chances of a good outcome.
Call 911 or go to the emergency room if you have chest pain or discomfort lasting two minutes or more, severe trouble breathing, fainting, trouble speaking, or sudden weakness, dizziness, or change in vision. Stroke is a possible serious problem of endocarditis.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can check new symptoms, help coordinate infection and heart specialists, and follow up on your care after treatment.
Common questions
Is endocarditis serious?
Yes. Endocarditis is a rare but life-threatening disease. Getting treatment right away improves the chances of a good outcome.
What causes endocarditis?
Germs in the bloodstream that travel to the heart cause it. Bacteria are the most common cause. Fungi can also cause it, and sometimes no cause can be found.
How is endocarditis treated?
Most people get antibiotics through a vein in the hospital, then more antibiotics for weeks. People most often need treatment for 4 to 6 weeks. Some people also need surgery to replace a heart valve.
Can endocarditis be prevented?
You can take steps to prevent infections that may cause endocarditis. Brush and floss your teeth every day and see your dentist regularly. Avoid injecting drugs. People at higher risk may be told to take antibiotics before some dental procedures. Follow your doctor's instructions about this.
Sources
- MedlinePlus - Endocarditis
- National Heart, Lung, and Blood Institute - Heart Inflammation: Endocarditis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
