CVS infections

Question 1

Infective endocarditis def?

Answer 1

bacterial (or fungal) infection of heart valves or endocardium

Question 2

Types of endocarditis?

Answer 2

1. native valve IE
2. Prosthetic valve IE
3. IVDU-associated IE
4. Nosocomial IE

Question 3

Native IE RFs?

Answer 3

increased risk with

• congenital heart diseases,
• rheumatic fever,
• mitral valve prolapse,
• degenerative

Question 4

Native IE common pathogens?

Answer 4

viridans streptococi (oral flora, α-haemolytic)

Question 5

Prosthetic valve IE common pathogen?

Answer 5

coagulase negative staphylococi

Question 6

IVDU-associated IE pathogen?

Answer 6

staphylococus aureus

Question 7

Who gets Nosocomial IE?

Answer 7

• in elderly (>60)

- ass with iv lines

Question 8

3 Atypical causes of IE?

Answer 8

• coxiella burnetti
• Bartonella spp
• typheryma whipplei

Question 9

Q fever transmission ?

Answer 9

• from contact with animals

- requires blood on admission of 4 weeks post-admission

Question 10

Q fever organism?

Answer 10

coxiella burnetti

Question 11

Cat scratch disease organism?

Answer 11

Bartonella spp

Question 12

Examples of non serological IE organisms? ( cant culture in blood)

Answer 12

Bartonella spp

typheryma whipplei

Question 13

How to identify the non serological IE organisms?

Answer 13

requires 16s rRNA PCR on valve tissue to diagnose (sampled during surgery)

Question 14

Q fever abx?

Answer 14

tetracycline + hydroxychlorquine (>1 yr)

Question 15

Chlamydia abx?

Answer 15

tetracycline

Question 16

Prevention of IE?

Answer 16

Abx no longer used as prophylaxis for IE

Question 17

Hand signs of IE?

Answer 17

Osler’s node, Janeway lesion, splinter haemorrhages

Question 18

Eye sign of IE?

Answer 18

Roths spot (flame shaped haemorrhage in opthalmoscopy)