Infective Endocarditis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Infective Endocarditis?
A primary care doctor often starts the evaluation of endocarditis. You will usually be referred to a cardiologist, a heart specialist. An infectious disease doctor, who treats serious infections, often helps with treatment. 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 infective endocarditis?
Endocarditis is inflammation of the inside lining of the heart chambers and heart valves. It is usually caused by an infection. The infection is most often caused by bacteria, which are germs, and rarely by a fungus.
Endocarditis begins when germs enter the bloodstream and then travel to the heart. It is rare but can be life-threatening and needs urgent treatment.
Symptoms
Symptoms of endocarditis may develop slowly or suddenly.
Symptoms can include:
- A high fever, or feeling hot, cold, or shivery.
- Night sweats, which means sweating a lot during the night.
- Feeling very tired.
- Joint or muscle pain.
- Feeling short of breath.
- Headaches.
- Losing your appetite or losing weight without trying to.
- Swelling of the feet, legs, or belly.
- Red spots on the palms of your hands or the soles of your feet.
- Small dark spots or dark lines under your fingernails.
The symptoms sometimes appear quickly over a few days but often come on slowly over weeks or months.
Causes and who gets it
Endocarditis usually happens when bacteria or fungus gets into your blood through your mouth or skin and travels to your heart. This could be during a dental procedure or through a cut or scrape. Germs can also get in through injection drug use with unclean needles. In some cases, no cause can be found.
Anyone can get endocarditis, but it is more common in men and people over 50. Some people have a higher risk, such as people who have heart valve disease or an artificial heart valve. Other risk factors include a birth defect of the heart or having had endocarditis before. A long-term line placed in a vein also raises the risk.
How doctors diagnose it
A provider may detect a new heart murmur, or a change in an existing heart murmur. A blood culture is a test that finds the germ causing the infection. An echocardiogram is a test that looks at the heart valves.
Other tests can include samples of your blood and urine, a chest X-ray, and an MRI scan. Doctors may also do an electrocardiogram to see how your heart is working.
Treatment
Treatment usually involves medicine and sometimes surgery. You will be given antibiotic or antifungal medicine for 4 to 6 weeks to treat the infection. This usually starts in the hospital through a vein. Blood cultures and tests help your provider choose the best antibiotic.
If you feel well enough and tests show the infection is under control, you may be able to finish the IV medicine at home.
Around half of people who have endocarditis will need surgery to remove or repair damaged heart tissue or valves. Surgery is often needed when the infection breaks off in pieces and causes strokes or blockages of other arteries. It is also often needed when damaged heart valves lead to heart failure.
Many people fully recover, particularly if the infection is found and treated early. It can take several months to feel completely better, especially if you had surgery. You will need regular check-ups and blood tests during and after your recovery.
When to see a doctor
Get urgent medical advice if you have symptoms of endocarditis. During or after treatment, contact your provider if you have a fever that does not go away, blood in your urine, or weight loss without a change in diet.
Call 911 or go to the emergency room if you have chest pain lasting two minutes or more. Also call if you or someone with you has face weakness, weakness or numbness in one arm or down one side of the body, or speech problems. Also call if you have trouble breathing, faint, get blurred vision, or lose sight in one or both eyes. These can be signs of a stroke, which can be a complication 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. Either type of doctor can help you keep up with the regular check-ups and blood tests needed after treatment.
Common questions
Is infective endocarditis life threatening?
It can be, which is why it needs urgent treatment. Many people fully recover, especially when the infection is found and treated early.
How long does treatment for endocarditis last?
Most people need antibiotic medicine for 4 to 6 weeks. It may take several months to feel completely better, especially after surgery.
Will I need surgery for endocarditis?
Around half of people with endocarditis need surgery. The surgery removes or repairs damaged heart tissue or valves.
Can endocarditis come back?
Yes, you have a higher chance of getting endocarditis again after having it once. It is important to know the symptoms and get help quickly if you think you have it again.
Can endocarditis be prevented?
If you are at higher risk, you can take steps to lower your chance of getting it. Take care of your teeth and gums and have regular dental check-ups. The American Heart Association recommends preventive antibiotics for people at risk, such as those with prosthetic heart valves or a past history of endocarditis.
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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.
