Endocarditis?

Thank you in advance for your time.  Some brief history... I am 36yr. female.  I have a pacemaker, take coumadin, amiodarone, cardizem and midodrine for heart.  I had a pacemaker infection one year ago that required laser removal of 3 leads, 10 days of IV antibiotics before reimplant on the opposite side. Following surgery an echo. showed significant regurg. of the tricuspid valve.  It was thought to be vegetation until a TEE showed it to be regurg. I also have mitral regurg. mild to mod. and calcification.  I am having an echo. done next week.  It has been 15months since the last one.
Here is my issue. I had sinus surgery 2x this summer. The second was due to hemorrhage from the first, and a possible spinal fluid leak. I was in the hospital for 2 weeks. I also had a colonoscopy due to a new colitis infection.  Now I have been out of the hospital for about a month.  I have had problems since shortly after discharge with body aches and pains, weakness, weightloss, shortness of breath.  Over the last week I have felt much worse, just like the flu.. intense body aches, fever 99-101, sweats, weakness, short of breath on/off.  I finally saw my internist who mentioned a re-infection of the pacemaker or valve.  
Does this sound like a possibility?
When I go for my routine echo. should I tell them what has been going on with me?
Does endocarditis present this way?
Would an echo. surely show it?
Should I make an appointment with my cardiologist?
Any advice or imput would be very helpful.

[CCF-M.D.-MJM]

Hello CN,

Sorry to hear about your health problems.  Symptoms over an extended period of time (4 weeks) with a pacemaker or artificial valve merits consideration of infection.  First you need to prove there is an infection.  This is done by culturing the blood for bacteria.  If you have bacteria in your blood, the odds of a pacemaker infection is very high and your pacemaker will likely need removed and you will need weeks of antibiotics.

You should call your cardiologists office and atleast give them the option to see you.  YOu probably should have routine echo soon and if you continue to feel poorly, should be admitted to the hospital for evaluation.  I would not allow this to go too long without a hospital evaluation.  This may be related to another infection or complications of your surgeries, but your pacer deserves strong consideration as a source.

I hope you feel better soon.  Post some follow-up when you know what is or what is not causing your symptoms.  Good luck.