subacute bacterial endocarditis

subacute bacterial endocarditis

n. Abbr. SBE

A subacute bacterial infection of the endocardium or heart valves, most frequently seen in patients with congenital or acquired valvular or cardiac defects, characterized by a heart murmur and septicemia.

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subacute bacterial endocarditis (SBE),

a chronic bacterial infection of the valves of the heart. It is characterized by a slow, quiet onset with fever, heart murmur, splenomegaly, and development of clumps of abnormal tissue, called vegetations, around an intracardiac prosthesis or on the cusps of a valve. Various species of Streptococcus or Staphylococcus are commonly the cause of SBE. Dental procedures are associated with infection by Streptococcus viridans, surgical procedures with S. faecalis, and self-infection (especially by drug abusers) with Staphylococcus aureus. See also bacterial endocarditis, endocarditis, Janeway lesion.

observations The infected vegetations may separate from the valve or prosthesis and form emboli. Osler's nodes, petechiae, Roth's spots, and splinter hemorrhages under the fingernails are common manifestations of blood-borne metastases of these emboli. Bacteriologic examination of cultures of the blood may allow specific diagnosis and treatment.

interventions Treatment requires prolonged and regular administration of an antibiotic that is known to be effective against the causative organism. If a prosthesis has become infected, it is usually removed. Before surgery or a dental procedure, prophylactic antibiotics are given. During the acute phase of illness the fever is treated with antipyretic medication and bed rest; adequate high-protein diet and fluids are encouraged.

nursing considerations Bed rest and hospitalization may be necessary for several weeks. Emotional and psychologic support may help the patient adjust to the necessary inactivity and to understand that SBE is a chronic illness.

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subacute bacterial endocarditis

Subacute endocarditis Cardiology A chronic bacterial infection of the endocardium and heart valves eventually leading to valve destruction and deformity Prophylaxis Antibiotics to prevent SBE are recommended for Pts undergoing heart surgery (1) Prosthetic cardiac valve of all types; (2) Previous bacterial endocarditis; (3) Most congenital cardiac malformations; (4) Rheumatic and other acquired valvular dysfunction; (5) Hypertrophic cardiomyopathy; (6) Mitral valve prolapse with valvular regurgitation; antibiotics are also recommended for (1) Dental procedures known to induce gingival bleeding–this includes cleaning; (2) Uretheral catheterization in a Pt with a UTI; (3) Incision/drainage of infected tissue–antibiotics are pathogen-targeted; (4) Vaginal delivery in the presence of infection