Infective endocarditis Flashcards
(16 cards)
Symptoms of endocarditis
fever, fatigue, weight loss, malaise, headache
Signs of endocarditis
janeway lesions, osler nodes, splinter haemorrhages, clubbing, roth’s spots
CVS risks of endocarditis
MVP. aortic stenosis, rheumatic HD, prosthetic valve, cardiac surgery, previous IE, congenital HD, MR
Non-CVS risks of endocarditis
IV drug use, internal medical devices, AIDs, diabetes M, chronic skin infections, alcoholic cirrhosis, GI lesions
PMH indications for endocarditis
Prosthetic material, congenital HD, immunocomprimised
PSH indications for endocarditis
alcohol abuse, IV drug use, homelessness, dogs and cats
First line tests for endocarditis
FBC, CRP, U+ E, ESR, urinalysis, CXR, ECG, echo
If blood cultures are negative do these tests
PCR, gene amplification, serological tests, cell culture
How many cultures should be done
3 sets at different sites in 6 hours. in severe cases 2 sets and different sites within 2 hours.
What bacteria are responsible for endocarditis
STREP
Staph. aureus, epidermidis
Enteroccoci - faecilius, faecium, durans
chlamydia
Other microorganisms responsible for endocarditis
brucella, fungi, coxiella burnetti
Treatment for IE with a native valve
IV amoxicillin and gentamicin - 4 weeks
Treatment for IE with native valve and sepsis
IV vancomycin and gentamicin -4 weeks
Treatment for IE with a prosthetic valve
gentamicin, IV vancomycin and rifampicin - 6 weeks
Indications for surgery
HF, uncontrolled infection, abscess formation, leaflet perforation, fistula formation , AV heart block
Indications for prophylaxis
New valvular disease, valve replacement, structural congenital disease, hypertrophic cardiomyopathy, previous IE
