Endocarditis Flashcards
(13 cards)
characteristic lesions
vegetation on valves/chordae tendinae
3 ways pathogen enters blood stream
dental procedure
cannula/venepuncture
cystoscopy/prostatectomy
bacteria if dental procedure
strep viridans
what bacteria from cystoscopy or prostaectomy
enterococcus faecalis
bacteria if cannula
staph (MOST COMMON CAUSE OF ENDOCARD)
risk factors of endocarditis
valve disease, congenital heart defects, prosthetic heart valve, IVDU
symptoms of endocarditis
VARIABLE .,. high index of suspicion for at risk groups
a bit like TB FEVER for most pts night sweats coryzal symptoms sometimes NO chest pain fatigue off food joint pain
onset
variable
acute, rapidly progressive infection
but also
subacute/chronic disease, with nonspecific symptoms - eg, fatigue, low-grade fever, flu-like illness, polymyalgia-like symptoms, loss of appetite, back pain, pleuritic pain, abdominal symptoms, weight loss.
peripheral stigmata
roth spot
- splinter haemorrages (haemorrhages under nail tip)
- osler nodes (painful red lesions)
- janeway’s lesions not painful, red bits on palm/sole (caused by emboli from infection site)
- clubbing
2 v important tests endocard
trans-thoracic or trans-oesophageal echo
blood culture
rx
iv abx
what dx criteria and what’s included
duke’s
MAJOR
-blood culures +ve for typical organism
echo with +ve results
MINOR
- predisposing heart condition or IVDU
- fever
- vascular phenomenon: major emboli, intracranial haemorrhage, Janeway lesions
- immune phenomena: glomerulonerhitis, osler’s, roth spots, rheumatoid factr
- micrological culture that does no meet major crieria
need: 2 major, 1 major 3 minor, 5 minor
ECG change to watch out for in endocarditis
prolonged PR interval
can occur because aortic valve is near AV node. if infection is on this valve and spreads to node, it can delay conduction
