Infective endocarditis Flashcards
(7 cards)
What are the risk factors for endocarditis
- ) Prosthetic heart valve
- ) Injection drug use
- ) Dental procedures that cause BLEEDING
- ) Previous endocarditis
- ) Unrepaired cyanotic heart disease
What symptoms must you look out for to suspect that endocarditis is present
Fever + new-onset murmur
Once you determine that someone has fever and new-onset murmur for endocarditis, what is the next steps
Step 1: Blood cultures
Step 2: If blood cultures positive, proceed to TTE
Step 3: If TTE negative, proceed to TEE
Two positive blood cultures + positive echo = TEE
Note: HACEK organisms not on blood cultures
What would an abnormal echo show for endocarditis
Valvular vegetation or abscess or new partial dehiscence of prosthetic valve
What is the initial treatment for endocarditis
Empiric treatment: Vancomycin and gentamicin in combination for 4-6 weeks
Surgery if anatomic defects such as valve rupture, abscess, prosthetic valves, fungal, and embolic events
What organisms are capable of causing infective endocarditis
- ) Staph aureus
- ) Strep viridans
- ) Strep bovis - do colonoscopy too
- ) Strep epidermis
- ) Enterococci
You can also give prophylactic therapy for endocarditis but it depends on certain cardiac defects and procedures. What situations would you give it
Cardiac defects: Prosthetic valves, unrepaired cyanotic heart disease, previous endocarditis, transplant recipients (not murmurs or pacemakers)
Procedures: Dental procedures that cause bleeding (use amoxicillin), respiratory tract surgery, skin surgery (not scoping, ob/gyn procedures, or dental fillings)