Below is the disease/infection that led to the untimely passing of Doug Gentry:

Infectious endocarditis is an infection of the lining of the heart chambers and heart valves, caused by bacteria, fungi, or other infectious agents.

Causes, incidence, and risk factors
Infectious endocarditis is an inflammation of the heart valves. Endocarditis is distinguished from infections of heart muscle (myocarditis) or the lining of the heart (pericarditis). Most people who develop infectious endocarditis have underlying heart disease.

Endocarditis is usually a result of bacteremia (bacteria in the blood), which is common during dental, upper respiratory, urologic, and lower gastrointestinal diagnostic and surgical procedures. The bacteria in the bloodstream can settle on damaged heart valves, and grow to create a “vegetation” or clump of live bacteria. These growths may form infected clots that break off and travel to the brain, lungs, kidneys, or spleen.

Many bacteria can cause endocarditis in patients with underlying valve problems, but an organism commonly found in the mouth, Streptococcus viridans, is responsible for approximately half of all bacterial endocarditis. Other common organisms include Staphylococcus aureus and enterococcus. Less common organisms include pseudomonas, serratia, and candida. Staphylococcus aureus can infect normal heart valves, and is the most common cause of infectious endocarditis in intravenous drug users.

Symptoms of endocarditis may develop slowly (subacute) or suddenly (acute). Fever is a hallmark of both. In the slower form, fever may be present on a daily basis for months before other symptoms appear. Other symptoms are nonspecific, such as fatigue, malaise (general discomfort), headache, and night sweats. As the illness progresses, small dark lines, called splinter hemorrhages, may appear under the fingernails.

The health care provider may hear changing murmurs in the heart and detect an enlarged spleen and mild anemia. Murmurs result from changes in blood flow across valves when clumps of bacteria, fibrin and cellular debris, called vegetations, collect on the heart valves. The mitral valve is most commonly affected, followed by the aortic valve.

Preexisting conditions that increase the likelihood of developing endocarditis include:
Congenital (present at birth) heart disease (atrial septal defect, patent ductus arteriosus, and others)
Prior rheumatic heart disease
Cardiac valve anomalies (such as mitral insufficiency)
Artificial heart valves
Since Streptococcus viridans is often found in the mouth, dental procedures are the most common cause of bacterial endocarditis. This can put children with congenital heart conditions at risk. As a result, it is common practice for children with some forms of congenital heart disease, and adults with certain heart-valve conditions to start on antibiotics prior to any dental work.

Symptoms
Fatigue
Weakness
Fever
Chills
Night sweats (may be severe)
Weight loss
Muscle aches and pains
Heart murmur
Shortness of breath with activity
Swelling of feet, legs, abdomen
Blood in the urine
Excessive sweating
Red, painless skin spots on the palms and soles (Janeway lesions)
Paleness
Nail abnormalities (splinter hemorrhages under the nails)
Joint pain
Abnormal urine color
Red, painful nodes (Osler's nodes) in the pads of the fingers and toes
Signs and tests

A history of congenital heart disease raises the level of suspicion. A physical examination may show an enlarged spleen. The examiner may detect a new heart murmur, or a change in a previous heart murmur. Examination of the nails may show splinter hemorrhages. Eye examination may show retinal hemorrhages with a central area of clearing, called Roth's spots.



Hospitalization is required initially to administer intravenous antibiotics. Long-term, high-dose antibiotic trearment is required to eradicate the bacteria from the vegetations on the valves. Treatment is usually administered for 4-6 weeks, depending on the organism. The chosen antibiotic must be specific for the organism causing the condition. This is determined by the blood culture and the sensitivities tests.

If heart failure develops as a result of damaged heart valves, surgery to replace the affected heart valve may be needed.

Either way, it is good news that Doug was able to catch what was going wrong with his body, as this disease/infection can be fatal.

DOI wishes Doug the best during his recovery.

Sean "The MiC" McCaffrey
BULLSMC@aol.com