Endocarditis notes Flashcards Preview

From Flashcardlet big > Endocarditis notes > Flashcards

Flashcards in Endocarditis notes Deck (15):
1

Most common early endocarditis organisms in prosthetic valve are

Staph
fungal
gram-negative bacilli

2

What are the most common in late (>1year) prostetic valve endocarditis

Streptocoous bovis
Enterocococci

3

What are indications for operation in Prosthetic valve endocarditis

1. Heart Failure
severe prosthetic dysfunction (obstruction/dehisence) causing pulmonary edema/cardiogenic shock
fistula to cardiac chamber/pericaridum
severe without dehesisance
2. Uncontrolled infection
Local uncontrolled abscess
Staph or gram negative
persistent blood cultures x 7 days
3. Prevention of embolism
Large isolated vegetation > 15 mm (IIB)
prevention of recurrent emboli
large vegetation *>10mm) with other signs of CHF

4

What is sensitivity of Duke Criteria

70-80% in native valve and less in PVE

5

What are outcomes and predictors of progrnosis with early native valve prosthetic endocarditis

20-40% mortality
age
staphylococcal infection
early PVE
HF
stroke
intracardiac abscess

6

What are the HACEK group

Haemophilus parainfluenza
Actinobacilus
Cardiobacterium
Eikenella orrodens
Kingellae

This is a fastidious group of organisms that is associated with negative blood cultures

7

Antibiotic prophylaxis is not recommended for the following

Colonscopy
Cystosocopy
TEE
any skin and soft tissue injuries
Intubation
Brochoscopy
Body piercing

8

What are drugs of choice for dental prophylaxis

Amoxicillin 2 g po pr iv (30 or 60 minutes) before procedure

if allergy

Clindamycin 600 mg po or iv

9

What are recommedations for previous cardiac vavular surgery

Peri-operative antibiotic should be recommended
No dental surgery for 2 weeks before valvular surgery

10

Which patients are recommended to have prophylaxis during high risk procedures

1. with a prosthetic valve or a prosthetic material used for cardiac valve repair
2. pts with previous IE
3. Patients with congenital heart disease
cyanotic heart lesions, without surgical repair or with residual defects, palliative shunts or conduits
congenital heart disease with complete repair with prosthetic material placed by surgery or by percutaneous technique, up to 6 months after the procedure
when a residual defect persists at the site of implantation of a prosthetic material or device by cardiac surgery or percutaneous technique

11

What is considered a high risk procedure

Manipulation of the gingival or periapical region of teeth or perforation of the oral mucosa (inlcuding scaling and root canal procedures)

12

What are other high risk procedures where you could consider prophylaxis

Resp procedures that involve draining infection (invasive resp tract procedure)
GI and GU--wound infection or sepsis
Dermatological or skin---infected skin (including oral abscesses), skin structure or MSK tissue its reasonable to cover

13

What is name for endocarditis resulting from advanced malignancy

marantic endocarditis

14

What cardiac tumor is often mistaken for endocarditis

fibroelastoma

15

What is Libman-Sacks Endocarditis

described in 1924, is the pathognomonic valvular lesion of systemic lupus erythematosus
or antiphsopholipid antibody syndrome that may develop on the endocardial surface of the heart

usually on the left and on the ventricular surface of the mitral valve

pea sized, (3-4mm) flat or slightly raised, granular, gray or pinkish projections, densely adherent to the endocardium, occur more at the valve rings and commissure

Decks in From Flashcardlet big Class (79):