Infective Endocarditis

Question 1

What does infective endocarditis present as

Answer 1

Pyrexia of Unknown Origin

Anorexia, WL, malaise, fatigue, rigors, night sweats

Question 2

What are RF for IE

Answer 2

Rh F 
Congenital heart disease 
Valve replacement
Long-term lines 
Bacteraemia

Question 3

What do you hear/see on examination of IE

Answer 3

Heart murmur

Clupping, splkinter haemorrhages
Osler nodes (painful nodules on dorsum of fingers) 
Janeway lesions (flat, on palms)

Roth spots on fundoscopy

Question 4

What criteria do you use for infective endocarditis

Answer 4

Dukes criteria
- 2 major

OR

• 1 major + 3 minor

Question 5

Whhat are major criteria in Dukes

Answer 5

Persistent bacteraemia via >=2 + cultures
Vegetations on echo
+ve serology for bartonella, coxiella, brucella

Question 6

What are investigations for IE

Answer 6

Urinalysis
FBC with low Hb
U&E, CRP

3x blood cultures
serology (if culture -ve)
CXR
Echo

Question 7

How many blood cultures do you need for IE

Answer 7

min 3

BEFORE antibiotics

From different sites

Question 8

What valve is most commonly affected in IE

Answer 8

Mitral + aortic

Question 9

What valve is most commonly affected in IVDU

Answer 9

Tricuspid

Question 10

What is the causative agent for low virulencer SUBACUTE endocarditis

Answer 10

S viridans

Question 11

What is the caustive agent for acule FULMINANT endocarditis

Answer 11

Coag negative staphylococci

Question 12

What is the general treatment and duration for endocarditis

Answer 12

Antibiotics

for 6 weeks