Bacterial Endocarditis - Background Flashcards
1
Q
A ? and a new ? is infective endocarditis until proven otherwise
2 groups of cases - patients with structurally ? heart valves and patients with structural abnormality such as ? disease, valve ? or ? cardiac defects
A
fever murmur normal valve replacements congenital
2
Q
Structurally abnormal heart
-? onset, caused by normal ?/skin commensals that enter the ? in trivial episodes of ?, then become meshed in ? aggregates on abnormal ? and proliferate
A
insidious GI blood bacteraemia platelet endocardium
3
Q
Pts with normal hearts
-?, fulminating presx, with ? organisms that directly invade the valve, seen in ??, after ? heart surgery or following ?
most common bacteria is ? ? with ? ? and strep epidermis also seen
A
acute pathogenic IVDUs open septicaemia strep viridans staph aureus
4
Q
Classical presx
- ? febrile illness, plus a new ?
- however may presx with ? illness (malaise, lethargy, ?, ?) and thus a high index of suspicion is required
- other prex may be with ? infarctions or ??? due to immune complex deposition
A
acute murmur insidious anorexia arthralgia distal AKI
5
Q
O/E
- ? and changing new heart murmur
- microscopic ? (70%)
- ? (40%)
- ? nodes 15% - ? ? nodules in finger - immune complex deposition
- clubbing 10%
- ? haemorrhages 10%
- ? spots - 5% - pale areas with surrounding haemorrhage on the ?
- ? lesions - painless ?/plantar macules
- ? rash
- ? infarcts
A
fever haematuria splenomegaly osler red tender splinter roth retina janeway palmar petechial digital
