Flashcards in CIS Microbiology of Heart Disease--Hersh Deck (24)
subacute vs acute Infective Endocarditis?
- rapid onset (less than 7 days), toxic-appearing, super sick!!
-no underlying heart disease
-R more than L (Tri>Bi>aorta>pulmonary)
-SOB, high fever, chills, pleuritic chest pain, back pain
-underlying heart disease
-L more than R
-S viridans, HACEK, enterococcus
-low grade fever, anorexia, fatigue, N/V
IE- risk factors
-age older than 60; males
-IV drug use
-predisposing conditions- valves!
signs of IE
-janeway lesions (painless- pams, soles)
-osler nodes (painful- fingers)
workup for subacute IE?
-blood cultures x 3, TTE (transthoracic echocardiogram)
-G+ cocci in clusters, catalase positive, coagulase negative
what is empiric treatment?
-broad coverage! until you get cultures back
best empiric treatment for IE?
vancomycin and ceftriaxone!!
dental work- subacute IE- which organism?
duke criteria- major?
-positive blood culture
-electrocardiograph changes consistent with valvular disease
duke criteria- minor?
-fever greater than 38 C
-immunologic phenomenon (GN, roth spots, osler nodes)
-vascular phenomenon (janeway lesions)
duke criteria- diagnosis
-2 major criteria
-1 major with 3 minor
when to use antibiotic prophylaxis for IE?
-cardiac conditions with high risk of IE- dental procedures
-if alleregic- cephalexin, clindamycin
empiric treatment for IE?
-vancomycin + ceftriaxone
-grow on bile salts culture
treatment for tb acute pericarditis
treatment for pericarditis
-aspirin + colchicine
treatment for pericarditis that doesnt respond to aspirin
-colchicine + high dose corticosteroids
most common cause of pericardiits?
-Coxsackie B (also Echovirus, flu
other causes of pericarditis
-Dressler- post MI
-anterior pleuritic chest pain (uremic pts- painless)
-pericardial rub (very specific!!)
Coxsackie virus B- morphology
-ssRNA naked icosahedral virus
(smallest virus)- picornavirus!
used in acute pericarditis to follow progress?
pericarditis- EKG progression
-diffuse ST elevation in all leads!
-inverted T waves
-return to baseline