Infective Endocarditis

Question 1

what are some causes of bacteraemia

Answer 1

translocation from infective source
IVDU
dental procedures

Question 2

apart from bacteraemia what does IE need to colonise the endocardium

Answer 2

endocardial insult
- turbulent blood flow
- particles from IVDU
- mechanical damage
- chronic inflammation

Question 3

what are some complications of infective endocarditis

Answer 3

valvular insufficiency
aortic root abscess
septic emboli - stroke, MI, spleen, renal, lungs
abscess of the cerebellum, spleen
mycotic aneurism
glomerulonephritis

Question 4

symptoms of infective endocarditis

Answer 4

fever
night sweats
fatigue
chest pain
dyspnoea
haematuria (if renal involvement)

Question 5

signs of infective endocarditis

Answer 5

new heart murmur
splinter haemorrhages

janeway leisons
- painless, on palms and soles

osler nodes
- painful, tips of fingers and toes

roth spots
- small white centred retinal haemorrhages

Question 6

risk factors for infective endocarditis

Answer 6

structural heart disease
- previous RF, iatrogenic, congenital
IVDU
immunocompromised state
exposure to health care setting

Question 7

most common causative organisms of infective endocarditis

Answer 7

staphylococcus aureus (IVDU)
streptococcus viridans
streptococcus pneumonia (alcoholism, prosthetic valve)
staph epidermis (prosthetic valve)

Question 8

what criteria is used to diagnose IE

Answer 8

modified dukes criteria

Question 9

treatment of infective endocarditis

Answer 9

IV ABX
course for 2-6 weeks
vancomycin or ceftriaxone till sensitivity’s are back

may require valve replacement