Infective endocarditis Flashcards

(7 cards)

1
Q

What are the risk factors for endocarditis

A
  1. ) Prosthetic heart valve
  2. ) Injection drug use
  3. ) Dental procedures that cause BLEEDING
  4. ) Previous endocarditis
  5. ) Unrepaired cyanotic heart disease
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2
Q

What symptoms must you look out for to suspect that endocarditis is present

A

Fever + new-onset murmur

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3
Q

Once you determine that someone has fever and new-onset murmur for endocarditis, what is the next steps

A

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

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4
Q

What would an abnormal echo show for endocarditis

A

Valvular vegetation or abscess or new partial dehiscence of prosthetic valve

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5
Q

What is the initial treatment for endocarditis

A

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

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6
Q

What organisms are capable of causing infective endocarditis

A
  1. ) Staph aureus
  2. ) Strep viridans
  3. ) Strep bovis - do colonoscopy too
  4. ) Strep epidermis
  5. ) Enterococci
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7
Q

You can also give prophylactic therapy for endocarditis but it depends on certain cardiac defects and procedures. What situations would you give it

A

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)

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