Flashcards in MHD: Cardiac infections Deck (18):
List the heart valves in order of most likely to least likely to be affected by endocarditis
Mitral, aortic, tricuspid, pulmonary
What are the two types of infective endocarditis?
Subacute: associated with viridans Strep
Acute: associated with Staph aureus
What organisms are most likely to infect a native heart valve?
What organisms are most likely to infect a prosthetic heart valve
What organisms are most likely to infect a prosthetic heart valve >2 months after surgery?
What organisms are most likely to cause infective endocarditis in IV drug users?
G- bacilli (Pseudomonas)
What is the most common cause of IE in community hospitals?
What are the HACEK organisms?
What are the characteristic lesions associated with IE?
What is the mechanism for lesion formation in IE?
Vegetations dislodge from valve surface and embolize to small vessels
What are the most common physical exam findings in infectious endocarditis?
Peripheral lesions are far less frequent (
What is the timing difference between acute and subacute endocarditis?
Acute: rapid onset, 2-5 days
Subacute: 2-5 weeks
What is nonbacterial thrombotic endocarditis?
Tissue damage of a valve leads to formation of a thrombus. This thrombus can serve as a site for microorganism attachment
What property do organisms that are associated with IE have that non-associated organisms do not?
IE causing organisms adhere more avidly to normal heart valves due to adhesins: dextran, Fim A attach to damaged epithelia
What are the major lab studies for confirming diagnosis of infective endocarditis?
Blood cultures: growth from more than 1 sample
Transesophageal echocardiography: valve damage visible
What are the minor criteria for diagnosis of infective endocarditis?
1) Predisposing heart disease or IV drug use
2) High body temperature
3) Evidence of vascular phenomena
4) Immunological phenomena
5) Microbiologic evidence
General, how is infective endocarditis treated?
Combination antimicrobial therapy for several weeks