Flashcards in Infective Endocarditis Deck (19):
What is the first test you should order to determine the etiologic cause of IE?
What are Osler nodes?
Painful nodules on the palms and soles
What are Janeway lesions?
non-tender flat lesions on palms and soles
What are Roth spots?
Small vegetative emboli to the retina
List some symptoms of IE
Vegetation seen on echo
What 4 organisms (or groups of organisms) are most likely to cause bacterial endocarditis?
Name the organisms in the HACEK Group
What are common reasons for negative blood cultures in endocarditis?
Fastidious organisms (hard to grow -- Anaerobes, HACEK)
Prior administration of antibiotics
Non infective endocarditis
What valve is most commonly infected in IVDA IE?
What organism most commonly causes IE in IVDAs?
When should you start antibiotics when IE is suspected?
Wait until the blood cultures are positive
Definitive Duke Criteria for IE
Microorganisms shown by culture or histology in a vegetation
pathologic lesions (vegetation of intracardiac abscess present)
Major Duke Criteria for iE
Persistently + blood cultures for typical organism
Typical findings on echo
Endocardial damage (new regurgitant murmur)
Serological or cultural evidence of Coxiella burnetti
Minor Duke Criteria for IE
Vascular phenomena (embolism, Janeway lesions)
What other test in addition to blood cultures could confirm diagnosis?
Why do we prefer transesophageal echo to transthoracic?
Transesophageal has over 90% likelihood of detecting a vegetation, while transthoracic only has 65%
What toxicities should you worry about with aminoglycosides?
Nephrotoxicity and Ototoxicity
How long do you treat endocarditis?
Prolonged therapy is indicated (2-6 weeks)