Infective Endocarditis

Question 1

Most common causative organism of infective endocarditis?

Answer 1

Staph aureus
Staph epidermidis if less than 2 months post valve surgery

Question 2

Risk factors for infective endocarditis?

Answer 2

IVDU
Poor dentition
Valvular conditions, rheumatic heart disease, mitral valve prolapse
Prosthetic valve
HIV
Haemodialysis

Question 3

Symptoms and signs of infective endocarditis?

Answer 3

Fever: most common symptom.
Night sweats, Anorexia, Weight loss, Myalgia
Less common sx:
Headache
Arthalgia
Abdominal Pain
Cough
Pleuritic pain

Signs: splinter haemorrhage, petechiae, Janeway lesions, Osler nodes, roth spots, splenomegaly, finger clubbing

Question 4

Investigations for infective endocarditis?

Answer 4

ECG - increasing PR prolongation in aortic root abscess
Urine dip - haematuria in glomerulonephritis
FBC
Blood cultures
Echocardiogram, PET CT for septic emboli

Question 5

Indications for surgery in a patient with infective endocarditis?

Answer 5

Patient has aortic root abscess
Haemodynamically unstable
Severe heart failure

Question 6

Complications of infective endocarditis?

Answer 6

Heart failure
Stroke, brain abscess, intercranial haemorrhage
Osteomyelitis
Septic arthritis