Aani Micro: Endocarditis Flashcards
Which organism causes acute infective endocarditis?
Staph Aureus
prosthetic valve = Coagulase-NEG staphylococci (staph epidermidis)
Which organism causes subacute infective endocarditis?
Strep Viridians
What are the differences between subacute and acute endocarditis?
Acute: fast
On normal heart valves
Echo shows large vegetations
Severe disease
Subacute: slow
On abnormal heart valves
Echo shows small vegetations
Mild/mod illness
Which organism is most likely to cause prosthetic valve bacterial endocarditis?
Coagulase-negative staphylococci
How to investigate for infective endocarditis?
3 x blood cultures 6 hours apart U&Es (haematuria might show due to immune complexes) CRP FBC CXR Echo
How to treat prosthetic valve endocarditis?
Vanc + Gent + Rifamp
How to treat Strep Viridians?
Benzylpenicillin + Gent
How to treat regular native valve endocarditis?
Flucloxacillin
How to treat MRSA endocarditis?
Vancomycin + Gent + Rifamp + Fucidin
Which valves are commonly affected in endocarditis?
Mitral and Aortic
Tricuspid in IVDU
Which criteria is used to diagnose infective endocarditis?
Dukes criteria
Explain dukes criteria
You need either 2 majors, 1 major and 3 minors or 5 minors to make the diagnosis.
The major criteria are:
1. Echo vegetations seen
2. 2+ positive blood cultures
3. + serology for bartonella, coxiella or brucella
The minor criteria are:
1. Rfs e.g. IVDU/murmur
2. Fever above 38 degrees
3. Immune complex formation e.g. splinter haemorrhages
4. Vasc phenomenon (stroke/PE etc)
5. Positive echo that doesn’t show vegetations
6. 1 positive blood culture
What is special about the HACEK group?
They cause gram negative bacilli endocarditis
What is in the HACEK group?
Haemophilus Parainfluenza Aggregatibacter/acintobacter Cardiobacterium hominis Eikenella Corrodens KIngela Kingae
if strep bovis is found what investigation must be done
colonoscopy
