Flashcards in Microbiology of Infectious Endocarditis Deck (25):
How serious is infective endocarditis?
life threateningly serious
What 2 microorganisms account for 80% of all cases of infectious endocarditis?
Staph and Strep
What microorganism causes Rheumatic heart disease?
Strep pyogenes (group A strep)= gram (+) cocci in chains
What can help make the diagnosis of infective endocarditis?
petechiae on buccal mucosa and/or extremities
(not always present though).
Where is infective endocarditis a big problem due to rheumatic heart disease?
India, southeast Asia, and central Africa.
What will strep pyogenes do to the epithelial cells of the pharynx?
disorganizes them, increasing likelihood of antibodies cross-reacting with collagen, leading to rheumatic heart disease.
What is the most common heart valve affected in RHEUMATIC fever (not endocarditis per say)?
What are the symptoms of rheumatic fever?
fever, polyarthritis (arthritis that jumps to different joints), carditis, chorea (uncontrolled movements), erythema marginatum (rash), subcutaneous nodules
Is rheumatic heart disease a disease of poverty?
How long does rheumatic fever take to present following strep throat?
What is the progression of group A strep?
- primordial prevention = improving social determinants of health
- primary= Rx initial infections
- secondary= antibiotic prophylaxis following acute rheumatic fever
- tertiary= med/surg management of rheumatic heart disease
What is the saying for group A strep's role in RHD?
"it licks the joints but bites the heart"
**What bacteria is the most common bacteria that causes infective endocarditis in IVDU?
Staph aureus and this goes to the RIGHT side of the heart (due to venous drainage).
What are some peripheral manifestations of IE (not RHD, but this may result DUE to RHD)?
- splinter hemorrhages in the nail beds
- Osler nodes (tender) on the digits. "O= OUCH"
- Janeway lesions (nontender)
- conjunctival petechiae
- Roth spots (seen on the retina)
Is strep viridans alpha or beta hemolytic strep?
VIRIDANS= alpha hemolytic.
How do you test for clubbing of the fingers?
but the two thumbs nails together and look for a diamond shape. If the space is not there, then there is clubbing of the fingers (Schamroth's sign).
What would nail beds look like with iron deficiency?
Koilonychia= concavity of the nail
What is Quincke's pulse?
alternate flushing and blanching of nail beds in concert with cardiac cycle (sever/chronic aortic insufficiency).
What is the first thing you should do if you suspect IE?
get a TTE
What is a vegetation on a valve?
a dense aggregate of microorganisms, platelet-rich thrombus, and inflammatory leukocytes.
What is the link associated with strep bovis?
**What are the HACEK organisms associated with ID?
**What are some classic culture-negative IE pathogens?
- Bartonella henselae
- Coxiella burnetti (Q fever)
- Tropheryma whipplei
When is prophylaxis recommended?
only in those with prostehtic cardiac valves, previous IE, or CHD.