Chest Pain and Fever II Flashcards
fever of unknown origin
3 weeks or longer with 1 week of unknown workup
fever
PGE2
its release stimulated by IL1, IL6, and TNFalpha
causes of FUO
infection, cancer, autoimmune/CT disease
duke criteria
for endocaritis
two major
or one major and 3 minor
or 5 minor
major - two positive blood cultures, echo evidence, new regurg murmur
minor - predisposing condition, fever, vascular emboli (janeway/osler/roth), immuno with agglutinating bodies
common bug for endocarditis
bartonella hensalae or quintana
Tx - doxycycline and gentamicin
acute endocarditis
virulent organisms
valvulr regurg, high fever, early emboli
native valve endocarditis
brushing teeth, IV device
staph
or strep viridans
or HACEK
IV drug users
staph to tricuspid valve
early prostethic valve infection
within 2 months
-coagulase + and - staph
late prosthetic valve infection
strep or staph
coag - and +
Dx of endocarditis
3 cultures one hour apart
use dukes criteria
-2 positive cultures
HACEK
takes a long time to culture
negative culture in suspected endocarditis
could be HACEK group
-eikenella, kingella**
complications of endocarditis
heart block CHF emboli mycotic aneurysms myocardial abscess
prosthetic aortic valve infection
coxiella burnetii
if owned cat
Tx for coxiella infection
doxycycline if acute
doxycycline + rifampin if chronic