Endocarditis leading to AVR - my story

[Raoul]

I had the same, first (normal) operation was the Ross procedure in decdmber last year.
After the operation i felt weak and had a small fever for aboou 3 weeks.
6 weeks later at my normal chechup the saw that my valve was leaqing a bit.
After some more tests they decided that i needed a new operation for a repair or a replecment.
The second operation was exactly 6 mounths after my first. When i wake up they told me a had a nad case of endocarditus and they had to do everything all over from the first operation (now a biological valve)
Also had the picc for 6 weeks and now for the rest of my life 1000mg of amoxiciline (to be sure it will not hapoen again).
Now 5 mounths later a feel fit and healthy again. Just finished the revalidation and everything is working fine.
I am a non smoker 46 year old men, always a healthy life (4 x sport, healthy food).

 

[pellicle]

Also had the picc for 6 weeks and now for the rest of my life 1000mg of amoxiciline (to be sure it will not hapoen again).

sorry to read that mate.

I was in a similar position, 500mg of amoxicillin 3 times daily after my infection (which happily was in the sternal wound not the endocardium).

It takes a while but eventually your GI develops a new flora and things improve. Took about a year for me.

 

[Gail in Ca]

Raul, do you take amoxicillin every day as a prophylaxis?
I wasn’t offered that!

 

[pellicle]

as a prophylaxis?

or (perhaps) in case its lurking somewhere inside his system. Depending on the bacteria they can have exceptionally durable methods including hiding behind a biofilm (which blocks antibiotics and the immune system).

 

[Raoul]

The docter told me that he could never be a 100% sure that the invection is all gone so he advised to take 2x 500 mg a day just te be sure...

 

[jimbob123]

A brief update to my story.

Yesterday I went for another transthoracic echocardiogram, the first one since surgery. My shiny new cow valve is performing well, with no regurgitation, so that's a huge relief.

The consultant who did yesterday's scan is the same person who saw me the first time around, pre-surgery and the day after I arrived into hospital. She told me yesterday that when she saw the scan on the previous occasion, she couldn't believe I was still functioning! There was so much regurgitation that she was amazed I was actually alive!

Sobering......

Jim

 

[ClickerTicker]

The endocarditis that knackered my Mitral Valve was fairly well entrenched. No messing around with Amoxicillin... I ended up being given Vancomycin, Netilmicin and Rifampin. These had to be given via a central line to avoid destroying the veins in the arm. The central line is inserted in the neck and goes directly into the jugular. It had four separate lumens - by the end of the five weeks or so I was on the stuff, only one lumen remained open.

Good way to lose weight as those heavy-duty antibiotics *really* hit your appetite - but I'd never sell it as a diet plan.
And I'll never forget the experience of the nurse pulling off the transparent dressing after my neck hair had been growing into it for five weeks.

I remained in hospital for a further week whilst they tweaked my INR - some six weeks in total, cost my insurance company so much I think the hospital should have named a wing after me.

 

[jimbob123]

The endocarditis that knackered my Mitral Valve was fairly well entrenched. No messing around with Amoxicillin... I ended up being given Vancomycin, Netilmicin and Rifampin. These had to be given via a central line to avoid destroying the veins in the arm. The central line is inserted in the neck and goes directly into the jugular. It had four separate lumens - by the end of the five weeks or so I was on the stuff, only one lumen remained open.

Good way to lose weight as those heavy-duty antibiotics *really* hit your appetite - but I'd never sell it as a diet plan.
And I'll never forget the experience of the nurse pulling off the transparent dressing after my neck hair had been growing into it for five weeks.

I remained in hospital for a further week whilst they tweaked my INR - some six weeks in total, cost my insurance company so much I think the hospital should have named a wing after me.

I also had issues with veins. During my first two weeks I had 13 cannulas, they kept giving up. And that was just with amox and Fluclox!

Before surgery I asked them to leave my central line in, which they did, and then five days after surgery I got a PICC so they removed the central. Even the PICC struggled, they could get the Fluclox in but it stopped working for bloods, it kept blocking.

 

[pellicle]

Hi

The docter told me that he could never be a 100% sure that the invection is all gone so he advised to take 2x 500 mg a day just te be sure...

basically the issue is that once you've had endo, you are more likely to get endo again. This does not only mean that its residual in you, it may also mean simply that the other risk factors have not gone away.

from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10292183/we find this (bold mine):

One of the major complications faced by patients who have recovered from a first episode of IE is recurrent IE. Risk factors for recurrent IE include intravenous (IV) drug use, prior episodes of IE, poor dentition, recent dental procedures, male gender, age over 65, prosthetic heart valve endocarditis, chronic dialysis, positive valve culture(s) obtained at the time of surgical intervention, and persistent postoperative fever. We present a case of a 40-year-old male with a history of former IV heroin use who experienced multiple episodes of recurrent IE caused by the same pathogen, Streptococcus mitis. This recurrence occurred despite the patient completing the appropriate course of antibiotic therapy, undergoing valvular replacement, and maintaining drug abstinence for two years.​

​

So because having had IE is an indicator for subsequent IE does not make it certain that it persisted, it could be because the causal issue (such as poor dental hygiene) hasn't gone away. Lets have a look at the Strep variant.

https://en.wikipedia.org/wiki/Streptococcus_mitis
the first sentence:

Streptococcus mitis is a mesophilic alpha-hemolytic species of Streptococcus that inhabits the oral cavity.​

well ... wouldn't ya know ... how would it get from the mouth into the blood?

Poor oral dentition?

Now I know a couple of addicts (not heroin) and while they will tell you "I've stayed clean" I happen to know they've had instances of lapse (usually singular at any given time but occasional). I say this because I know that you just can't trust an addict.

I also know that when looking for answers the simplest explanation is usually the correct one (but not always, the least likely may be the case because that one in a million chance is still possible if not probable).

Then there is the next problem which was identified early by the greeks (humans haven't changed) in this advice to other physicians by Hippocrates

Still discussed

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736034/

Have you ever lied to your patients or been surprised to learn that one of your patients lied to you? Have you considered it important to learn why lies emerge in the treatment relationship? ​

So I'm going to quote a saying I learned in Finland: "There is no fool, like the fool that you fool when you fool yourself".

Just make sure you properly attend to dentition. The only assessment of properly is done by your dentist. Ask him or her not to lie to you. Don't lie to yourself either, because only you will suffer.

Best Wishes

 

[lsquared18]

Hello all.
Going through Endo was probably worse than the surgery itself. I spiked a fever and next thing I know I was in CCU. They took bloods and it came back as Endo. They put me on Vanco IV straight away for 7 months. This was also during my second surgery. At first they tried a repair the mitral valve which blew they also closed a VSD hole during the first surgery. 4 days later they replaced the blown valve with the Mitral St Judes valve. I came out of surgery while doing Vanco IV until September. Then I was discharged. At that point I lost a tonne of weight. But gained it all back and now overweight. I need to lose poundage...

 

[pellicle]

Going through Endo was probably worse than the surgery itself.

I haven't had endo, but something close and I can vouch for this.

 

[lsquared18]

I haven't had endo, but something close and I can vouch for this.

I dont wish Endo on anyone even my worst enemy.