Paeds: Endocarditis Flashcards Preview

Final Notes > Paeds: Endocarditis > Flashcards

Flashcards in Paeds: Endocarditis Deck (13):
1

Children at risk

Those with turbulent blood flow through the heart or where prosthetic material has been inserted following surgery e.g.
- PDA or VSD
- Coarctation of aorta
- Previous rheumatic fever

2

Common pathogens

- Streptococcus viridans: often after dental procedures
- Staph. Aureus: related to central venous catheters
- Group D streptococcus (enterococcus): often after low GI surgery

3

Clinical Features:
early

Symptoms are mild
Prolonged fever over several months may be the only feature

4

Other presentation
acute

Rapid onset of high intermittent fever can occur

5

Non-specific symptoms

Myalgia and arthralgia
Headache
Weight loss
Night sweats

6


Examination:

1. Pallor/anaemia
2. Nail bed – splinter haemorrhages
3. Tender nodules: fingers/toes (Oslers nodes)
4. Erythematous palms/soles of feet (Janeway lesions)
5. Finger clubbing (Late)
6. Splenomegaly
7. Haematuria (microscopic)
8. Retinal infarcts (roth spots)
9. Heart murmurs (change in character with time)

7

Diagnosis:

1. Bloods:
a. FBC (raised WCC)
b. Raised ESR
c. Raised CRP
d. Repeated blood cultures
2. Echo look for vegetation’s

Prophylaxis: no longer routinely advised

8

Prophylaxis


Prophylaxis: no longer routinely advised

9

Treatment:
(3 things)

Antibiotic Therapy
Bed rest
Surgery

10

ABX

ASAP
Delays may result in progressive endocardial damage and deterioration in cardiac function

High dose IV antibiotics e.g. penicillin/vancomycin min. 6 weeks

11

Bed rest

Recommended and heart failure should be treated

12

Surgery

Surgery

13

Prognosis

1. Even with antibiotic Treatment mortality may be as high as 20% and complications 950-60%) include heart failure.
2. Systemic embolic from left-sided vegetation’s may result in brain abscess and stroke.

Decks in Final Notes Class (196):