Bacterial endocarditis

Question 1

Signs

Answer 1

Bacteria FROM JANE:

1) Fever
2) Roth’s spots: round white spot on retina surrounded by hemorrhage
3) Osler’s nodes: tender raised lesion on finger/toe pads
4) Murmur

5) Janeway lesions: small painless eryth lesion on palm/sole
6) Anemia
7) Nail-bed hemorrhage
8) Emboli

Question 2

Acute vs subacute

Answer 2

Acute: S aureus, large vegetation on previous normal valve

Chroni: viridan streptococci (low virulence), smaller vegetation on congenitally abn or diseased valves.

Question 3

Other causes

Answer 3

Malignancy,
hypercoagulable state,
lupus (marantic/thrombotic endocartitis)

S bovis from colon cancer
S. epidermidis on prosthetic valve

Question 4

Common valves used

Answer 4

Mitral valve most commonly involved;
Tricuspid with IV drug use: s aureus, pseudomonas, candida.
“don’t tri drugs”

Question 5

Complications

Answer 5

Chordae rupture,
glomerulonephritis,
suppurative pericarditis,
emboli.