3- Infective Endocarditis Flashcards
what is endocarditis
infection of the heart valves
What are common Endocarditis signs
Fever New or different Murmur Embolism Splenomegaly Osler nodes, Laneway lesions
What are Osler nodes
Painful lesions to finger and toe tips, thenar and hypothenar
Culture (-)
What are Janeway Lesions
Painless lesions to soles, palms, thenar and hypothenar
Culture (+)
What is Major Duke’s criteria for IE
2+ blood cultures
Echo evidence of endocardial involvement
What are Minor Duke’s criteria for IE
Predisposition (IVDU, heart condition) Fever >38 Vascular phenomenon Immunologic phenomenon 1+ blood culture
What are the most common infecting organisms in IE
- Streptococcus (Viridans)
- Staph (Epidermidis in PVE, Aureus in IVDU and venous cath)
- Enterococci (Faecilis)
- HACEK organisms
What are the HACEK organisms
Haemophilus parainfluenza Actinobacillus a. Cardiobacterium hominis Eikenella corrodens Kingella kingae
What is treatment for the most common organisms
Strep: penicillin G
Staph: Naficillin (for S. Aureus, 2 weeks naficillin or oxacillin+aminoglycoside)
Entero: Ampicillin
HACEK: high dose ampicillin+gentamicin 4 weeks
Who requires prophylaxis
High risk patients undergoing dental procedures that perforate oral mucosa and manipulate gingival tissue
What valvular lesions do NOT require prophylaxis
Bicuspid aorta
Mitral valve disease
HCM
What procedures do NOT require prophylaxis
Non-infected tissue injections
orthodontics
shedding dead teeth
bleeding from lips/mucosa
“high risk” patients means (for prophylaxis)
#1: underlying cardiac condition Prosthetic valve Hx IE cardiac transplant w/ valvulopathy CHD
What are S/E of Daptomycin
Myopathy
Rhabdomyolysis
What are S/E of Gentamicin
Nephrotoxicity
Ototoxicity
NM block
