How susceptible to SBE

[Christina L]

(subacute bacterial endocarditis) is a person after having the common cold or flu?

I am in the midst of the first cold I have had since my surgery in 11/2003. Despite being miserable from normal cold symptoms, should I be worried that I could get bacterial endocarditis?

How does one get a heart infection and how do you know you have it? Should a heart patient always seen a doctor when he/she has a cold or the flu?

I had my mitral valve repaired, not replaced. Does this make a difference - would I be more prone to SBE?

Thanks!

Christina L.

 

[Bryan B]

Hi Christina,

I think that since a cold or flu are viruses they shouldn't increase your risk for endocarditis. However a prolonged cold or flu could develop into a respiratory infection, and that could put you at an increased risk for BE. Anytime you're not sure about symptoms you are experiencing it never hurts to let your physician know about it.

 

[JimChicago]

Sorry I don't know the answer Christina - my own anecdotal experience has been the Sambucol product has helped me this season with colds.

An article about it -

From:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9395631
>>>>
: J Altern Complement Med. 1995 Winter;1(4):361-9. Related Articles, Links


Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama.

Zakay-Rones Z, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, Mumcuoglu M.

Department of Virology, Hebrew University-Hadassah Medical School, Jerusalem, Israel.

A standardized elderberry extract, Sambucol (SAM), reduced hemagglutination and inhibited replication of human influenza viruses.....

.... A significant improvement of the symptoms, including fever, was seen in 93.3% of the cases in the SAM-treated group within 2 days, whereas in the control group 91.7% of the patients showed an improvement within 6 days (p < 0.001). A complete cure was achieved within 2 to 3 days in nearly 90% of the SAM-treated group and within at least 6 days in the placebo group (p < 0.001). No satisfactory medication to cure influenza type A and B is available. Considering the efficacy of the extract in vitro on all strains of influenza virus tested, the clinical results, its low cost, and absence of side-effects, this preparation could offer a possibility for safe treatment for influenza A and B.
>>>>

 

[BillCobit]

(subacute bacterial endocarditis) is a person after having the common cold or flu?

I am in the midst of the first cold I have had since my surgery in 11/2003. Despite being miserable from normal cold symptoms, should I be worried that I could get bacterial endocarditis?

How does one get a heart infection and how do you know you have it? Should a heart patient always seen a doctor when he/she has a cold or the flu?

I had my mitral valve repaired, not replaced. Does this make a difference - would I be more prone to SBE?

Thanks!

Christina L.

Hi Christina

Turbulence caused by an abnormal flow through a valve (stenosis, leaky valve, etc) can damage the sensitive endothelial cells that line the heart. Blood platelets start to aggregate to patch the damaged bit, just as they would when you have a minor cut on your hand. However, tiny amounts of bacteria that may be floating around in your blood can glom on to this sticky patch, and can multiply...leading to bacterial endocarditis.

I had my mitral valve repaired, and have been warned by my doctors that it is still not normal, and I need to be conscientous about prophylactic antibiotics before dental procedures, GI procedures (e.g., gastric endoscopy, conlonoscopy, etc.), as these can introduce harmful bacteria.

Symptoms are kind of like the flu - w/o the respiratory involvement. Fever, chills, body ache, night sweats - and frequently last > 2 weeks. Blood work and echocardiography are used to confirm diagnosis. One of the problems in diagnosis that can be encountered happened to me. I had been sick for a bout 1.5 weeks, and went to a walk in clinic after work. I got a low-dose antibiotic and was sent on my way. It had no effect, so I went back. The second visit they did blood cultures and cell counts were inconclusive - probably because the antibiotic reduced bacteria levels but did not completely eliminate the infection. So we started down the path of Lyme disease, AIDS, and other stuff. The infection resolved through my own immune system, but not before my valve was trashed.

I'm dang lucky to be here!

My advice is ALWAYS remind doctors of you condition before any procedure that can cause bleeding - it's in your chart, but reminding them doesn't hurt.
Any fever that lasts more than a few days in the absence of other symptoms should also be looked at suspiciously - and don't just let a doc shrug and write you a script for an antibiotic and kick you out the door after a 5 second "exam."

Also, try not to be too paranoid

Stay well!

 

[Christina L]

Thank you

Thank you

all for the information and advice. I had a colonoscopy a month ago (which was negative by the way) and the gastroenterologist told me that they don't recommend antibiotics for the procedure any more for a person with valve disease. So, I didn't take any. I guess that was bad advice, huh?

Jim, I have never heard of Sambucol. I rarely get colds and/or flu, but Wayne brought this virus strain home from work and he had been hacking and coughing and miserable - how could I NOT get it? I tried washing my hands all the time, sleeping in another room, etc., but still got the darned virus.

My neighbor recommended Zicam which purports that it will lessen symptoms of a cold and also shorten the duration. So, I have been taking that.

ME not be paranoid??

I just don't want to go through heart surgery again any time soon, so am being cautious. Again, thanks for your help and Bill, I guess I didn't realize you had SBE before your valve repair(?). I was told also that my valve is not "normal" by one cardio even though it has been repaired.

Bryan - great advice - clear cut.

I will keep all of this in mind and hopefully this virus will be gone in a few days, if not and I feel worse - to the doctor I go!

Christina L.

 

[Christina L]

Pam,

Pam,

That is a whole other subject - motor homes and slow traffic going up and down the canyons!! They make me crazy, but I try to be polite and have patience (ha). What I don't get is they go very, very slow when there is no room to pass but when there is room to pass, they speed up. I think that is called "reverse road rage."

Yes, there is sickness (colds and flu) all around right now - no escaping it! Sorry to hear that you and your husband have been sick also.

This is an update on Zicam - Wayne just told me (why he waited I don't know) that Zicam can cause loss of smell. I looked it up on the internet and sure enough there are claims that it has caused loss of smell in people who have taken it. So, the Zicam is getting thrown out! If anyone out there is taking Zicam, be warned. I sure wouldn't want to lose my sense of smell!! The smell of coffee brewing, the pine trees and the mountain air - what an awful thing that would be to not be able to smell! So FYI everyone - make your own judgments.

Jim, think I will try the Sambucol.

Christina L.

 

[JimChicago]

I hope it helps for you too Christiana - you'll find it at any health food store or GNC - I myself anecdotally thought it lowered my INR a little but I can't be certain it was the cause - I just had to increase 2 mg more warfarin per week - I took Zicam too - thanks for the warning about loss of smell.

Turbulence caused by an abnormal flow through a valve (stenosis, leaky valve, etc) can damage the sensitive endothelial cells that line the heart. Blood platelets start to aggregate to patch the damaged bit, just as they would when you have a minor cut on your hand. However, tiny amounts of bacteria that may be floating around in your blood can glom on to this sticky patch, and can multiply...leading to bacterial endocarditis.

Thanks for that explanation Bill. The chain of events you describe sounds a lot like what some researchers speculate is involved in other heart disease as well. Like the discussion of the nanobacteria/calcification thing.
From:
http://pmj.bmjjournals.com/cgi/content/abstract/65/767/665
>>>>
The present report is the first description to our knowledge of a clinical case of bacterial calcification in human infective endocarditic vegetations. Partial calcification of bacteria within vegetations may be a further mechanism of bacterial protection from host defences and antibiotics. Similar calcification has recently been reported in vegetations formed on porcine valvular prostheses implanted experimentally in sheep.
>>>>>

It would almost make one wish there were ways of prophylactively continually supplementing against those little critters so as to stop them from messing up our heart tissue. But antibiotics are said to cause resistance if used for very long periods.

 

[BillCobit]

I had a colonoscopy a month ago (which was negative by the way) and the gastroenterologist told me that they don't recommend antibiotics for the procedure any more for a person with valve disease. So, I didn't take any. I guess that was bad advice, huh?

Christina L.

Well, I checked the AHA site (http://www.americanheart.org/presenter.jhtml?identifier=11086)...and colonoscopy doesn't show up as one of the high risk procedures. So no, it doesn't sound like bad advice and I stand corrrected!

Dental procedures for which endocarditis prophylaxis is recommended1

Dental extractions

Periodontal procedures including surgery, scaling, and root planing, probing, and recall maintenance

Endodontic (root canal) instrumentation or surgery only beyond the apex

Subgingival placement of antibiotic fibers or strips

Initial placement of orthodontic bands but not brackets

Intraligamentary local anesthetic injections

Prophylactic cleaning of teeth or implants where bleeding is anticipated

1Prophylaxis is recommended for patients with high- and moderate-risk cardiac conditions


--------------------------------------------------------------------------------

Other procedures for which endocarditis prophylaxis is recommended


Respiratory tract


Tonsillectomy and/or adenoidectomy

Surgical operations that involve respiratory mucosa

Bronchoscopy with a rigid bronchoscope

Gastrointestinal tract2


Sclerotherapy for esophageal varices

Esophageal stricture dilation
Endoscopic retrograde cholangiography with biliary obstruction

Biliary tract surgery

Surgical operations that involve intestinal mucosa

Genitourinary tract


Prostatic surgery

Cystoscopy

Urethral dilation

2Prophylaxis is recommended for high-risk patients; it is optional for medium-risk patients.

 

[Christina L]

Thanks Bill

Thanks Bill

and Jim. Glad to know that my gastroenterologist was correct with not recommending antibiotics for my colonoscopy, but you never know with doctors - you have to be your own doctor sometimes as we all know on this board!

Christina L.

 

[tommy]

Christina,

Sorry about your cold. And just when the weather is getting nicer.

I had antibiotics IV for my colonoscopy. I went round and round with the GI doc's office about prescribing antibiotics (insisted by my cardio), only to find it is SOP in the IV. GI procedures are inherently "dirty" with the possibility/probablility of snipping polyps. Maybe I'm over-reacting because my appendectomy got infected, but I won't do a colonoscopy without antibiotics.

Check with your anethesiologist about what stuff they put in you. You may have gotten antibiotics IV.

As far as getting SAB from a cold or flu, it would take a secondary bacterial infection to cause a problem. I used to get secondary bacterial infections resulting from persistent hay fever. The hay fever kept my sinuses irritated all season long. Add a cold and bacteria often came into play. Getting control of the hay fever has been a good thing. Mosts colds come and go (fewer colds too).

SAB is usually (always?) accompanied by fever - often low-grade, but persistent. The presence of bacteria can be simply detected by blood cultures.

It's natural to be concerned about SAB since it is so serious. If it eases your mind, check with your doctor. Don't sit and stew. When I'm feeling "punk", I take my temperature. If I were to have a fever for a week and/or typical antibiotics don't cure it, I'd take it to a higher level.

When I had SAB 20 years ago, I ignored a low-grade persistent fever for a couple of months. Tylenol would knock it down (not cure it, but mask it) for days. Sometime, the temperature would seem to disappear for over a week. I never made the connection. Once SAB was diagnosed and treated, I got regular blood cultures for a couple of months. At that time, the blood cultures were the definitive tool for SAB diagnosis and susequent absense of SAB. I suspect that is still the case, but don't know for sure (thank goodness).

Hope this helps.

 

[Bryan B]

I had a colonoscopy in December and I also had prophylactic IV antibiotics administered. My cardiologist recommended oral antibiotic pre-med consistent with what one would take for dental procedures, but my GI doc was adamant about using IV antibiotics...and since I had an IV going already that was fine with me. He removed 2 benign polyps so there was bleeding. I'm surprised that this would not be standard procedure for all colonoscopies for anyone with valvular disease.

 

[BillCobit]

He removed 2 benign polyps so there was bleeding. I'm surprised that this would not be standard procedure for all colonoscopies for anyone with valvular disease.

The polyp removal clearly puts you in the land of "Surgical operations that involve intestinal mucosa." But I'm also kinda surprised that a standard colonoscopy isn't on the list. Intuitively, it seems like a great way to introduce bacterial into the circulatory system.

 

[Bryan B]

That's what I was thinking too Bill. And also they don't know if there will be polyps to be removed until they get a looksee. I would hate to go through the prep twice because I wasn't given antibiotics before the procedure and they found polyps that needed to be removed. The prep is the worst part of the entire process.

 

[Christina L]

I think

I think

some of you are right - they may have put antibiotics in the fluids that I received during the colonoscopy. I just did not receive pre-procedure prophylactic antibiotics orally.

I was so keyed up about the colonoscopy, that antibiotics were the least of my worries. The colonoscopy was a breeze, just like everyone said. I highly encourage all over 50 or with symptoms to get the procedure. I had a few symptoms although there is no history of colon cancer in our family and happily I can report that my colonoscopy was 100% normal, no polyps, no nothing except a few internal hemorrhoids.

As for my cold, it is so irritating - did not get much sleep last night from the coughing and irritation in my throat. Thanks everyone for your great advice - I will watch the cold and if it does not go away in the same amount of time as Wayne's, I will get checked.

Christina L.