Bacteria And Their Association In Infective Endocarditis

Question 1

Native Valve Endocarditis

Answer 1

1. Viridans Streptococci
2. Streptoccocus bovis
3. Staphylococci

(Not sure if the most common one is 1 or 3)

Question 2

IV Drug Addict

Answer 2

1. Staph aureus
2. Candida

Question 3

Prosthetic Valve
(Early + Late Onset)

Answer 3

< 2 months post-surgery: Staph. epidermidis
> 2 months post-surgery: Viridans Streptococci

Question 4

GI/Genitourinary Procedures

Answer 4

Enterococcus Species

Question 5

Unpasteurized Dairy Products

Answer 5

Brucella spp.

Question 6

Fungi

Answer 6

1. Candida spp. (in iv drug users)
2. Aspergillus spp.

Question 7

Culture (-) Bacteria

Answer 7

1. Coxiella Burnetti
2. Chalmydia spp.
3. Legionella spp.
4. Mycoplasma pneumoniae

Question 8

Other Bacteria that are uncommon/rare (5)

Answer 8

1. Corynebacteriaspp.
2. Listeria spp.
3. Pseudomonas spp.
4. Enterobacterales
5. Brucella spp.

Question 9

Causes Aggressive IE

Answer 9

1. S. aureus
2. Pseudomonas aeruginosa
3. Aspergillus spp.

Question 10

What mediates the adhesion of bacteria to the endocardium?

Answer 10

• Dextran
• Fibrinogen Binding Proteins

Question 11

Management of Viridans streptococci?

Answer 11

(sensitive): Penicillin x 4 weeks IV
(resistant): Ampicillin + Gentamicin x 4 weeks

Question 12

Management of Staphylococcus aureus or epidermidis?

Answer 12

(sensitive): Flucloxacillin x 4-6 weeks
(resistant): Vancomycin x 4 weeks

Question 13

Management of HACEK?

Answer 13

ceftriaxone x 4 weeks

Question 14

Management of Coxiella burnetii?

Answer 14

doxycycline + ciprofloxacin x 2-3 years

Question 15

Management of Fungal IE?

Answer 15

Surgery + Antifungals

Question 16

Management of Fungal IE?

Answer 16

Surgery + Antifungals

Question 17

A p/x had recently undergone a dental procedure and developed IE, what is most likely the causative agent?

Answer 17

Viridans Streptococci