Infective Endocarditis

Question 1

What are the Duke’s minor criteria for infective endocarditis?

Answer 1

Vascular phenomena - splinter haemorrhages, laneway lesions,
Immunological phenomenoma - Osler’s nodes, Roth spots
Predisposing heart disease or IVDU
Microbiological evidence not sufficient to meet major criteria
Fever

Question 2

When would surgery be indicated in infective endocarditis?

Answer 2

Heart failure
Uncontrolled infection
Prevention in recurrent IE

Question 3

What investigations should be conducted in infective endocarditis?

Answer 3

Blood cultures x 3 (preferably prior to Abx)
ECHO
ECG
Bloods
Urinalysis

Question 4

What are the most common causative organisms of infective endocarditis?

Answer 4

Native valve IE - strep, enterococci, staph

Native valve IE + IVDU - Polymicrobial, s.aureus, strep, gram neg bacilli

Prosthetic - s.aureus, enterococcus, staph, gram neg bacilli

Question 5

Over what time period does infective endocarditis typically present?

Answer 5

Days to (6) weeks

Question 6

What are the potential presenting features of infective endocarditis?

Answer 6

Fever
New heart murmur
SOBOE
Orthopnoea
PND
Headache
Symptoms of stroke
Chest pain
Night sweats
Malaise
Fatigue
Anorexia
Weight loss
Myalgias
Roth spots (on fundoscopy)

Question 7

What is the difference between janeway lesions and Osler nodes?

Answer 7

Janeway lesions - haemmorhagic painless lesions on the palms and soles

Osler nodes - painful nodes on the fingers and toes