Symptoms Causes And Treatment

Signs and symptoms of Endocarditis

This disease is characterized by internal bleeding that is associated with other symptoms such as fatigue and aching joints and muscles. There are also observable leaks of blood in urine as observed under a microscope during laboratory tests. The internal bleeding is commonly caused by blunt trauma where a patient has been hurt by an object that are caused by blunt objects or shear forces. Headaches and disorientation are common among such patients. Internal bleeding is also quite commonly associated with swelling and paleness of the skin. Internal bleeding can slow lead to abdominal bleeding and continue as the blood continues to ooze. This condition is mainly caused by attack by germs (Dajani et., 1997, pg. 1450). Based on the symptoms described and the results of the laboratory tests, the diagnosis was correct and accurate, and so was the treatment.



Endocarditis is treated by administration of antibiotics to fight the bacteria accusing the disease (Mylonakis & Calderwood, 2001, pg.1380). While mild infections are treated using antibiotics, greater infections are treated through surgery. Some of the antibiotic drugs used to treat endocarditis include Warfarin, Fluoxetine, St. John’s wort, Ciprofloxacin and Prednisolone.

Potential drug-drug interactions

Antibiotics are known for their incessant drug interactions that may cause undesirable side effects to the user. In specific, warfarin is prone to potential side effects caused by its interaction with other drugs. Warfarin interacts with other drugs causing adverse reactions. The side effect related to this is the decrease in its effectiveness (Nutescu et al., 2006, pg. 445). This interferes with the bodies INR rate making its abnormally low or high. While using warfarin antibiotics treatment, one is not advised to take medication involving other drugs such as over-the-counter pain relievers, like ibuprofen (brand name Advil) and naproxen (brand name Aleve). This is because these drugs interact with warfarin causing an increase in the anticoagulant effects of warfarin which leads to likelihood of harmful bleeding (, 2016).

Warfarin is also known to interact with alcohols and some foods. Alcohol disturbs the rate at which the body metabolizes warfarin, leading to an increased level of bleeding. Major changes in diets can also cause increased risk of side effects resulting from drug-drug interactions between warfarin and some food substances. For example, an increased intake of vitamin K nutrient can lead to increased prothrombin time and the INR which could lead to major complications in the body, slowing the rate of recovering from this disease. Ciprofloxacin also interacts with warfarin causing adverse effects and foods such as caffeine (Polk, 1989, pg. 79).

Treat/monitoring plans

During monitoring, medical personnel should specifically look out for the heart murmur. This is because the presence of this disease can cause an additional or new heart beat, changing the whole heartbeat. A strange heart murmur may be an indication of heart failure through the disease. In addition, doctors should keep a close eye at the recurrent symptoms such as presence of blood in bodily fluids urine and vomit, pain, nausea, dizziness and confusion as well as the subsiding of the bruise. In addition, it would be important to keep a close eye on the prothrombin time to ensure that it resumes to the normal range of 11 to 13.5 seconds.

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  • Dajani, A.S., Taubert, K.A., Wilson, W., Bolger, A.F., Bayer, A., Ferrieri, P., Gewitz, M.H., Shulman, S.T., Nouri, S., Newburger, J.W. and Hutto, C., 1997. Prevention of bacterial endocarditis: recommendations by the American Heart Association. Clinical infectious diseases, 25(6), pp.1448-1458.
  • Mylonakis, E. and Calderwood, S.B., 2001. Infective endocarditis in adults. New England Journal of Medicine, 345(18), pp.1318-1330.
  • Nutescu, E.A., Shapiro, N.L., Ibrahim, S. and West, P., 2006. Warfarin and its interactions with foods, herbs and other dietary supplements. Expert opinion on drug safety, 5(3), pp.433-451.
  • Polk, R.E., 1989. Drug-drug interactions with ciprofloxacin and other fluoroquinolones. The American journal of medicine, 87(5), pp.S76-S81.
  • (2016). A Patient's Guide to Taking Warfarin. [online] Available at:
  • hmia/a-patients-guide-to-taking-warfarin [Accessed 21 Jan. 2019].

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