endocarditis 1 Flashcards
what can cause endothelial damage that results in colonization by bacteria
- jet lesions due to turbulent blood flow
- electrodes or catheters (pacemakers)
- IV drug abuse
what sites of involvement are included in left sided infective endocarditis?
mitral valve or aortic valve
left sided endocarditis has a higher risk of what
high risk of CNS stroke (strait shot to brain)
what sites of involvement are included in right sided infective endocarditis?
tricuspid valve pulmonary valve (rare)
who as at higher risk for right sided infective endocarditis
IV drag abusers
what are the risk factors for infective endocarditis
- chronic IV access
- heart failure
- IV drug abuse
- previous endocarditis
- prosthetic valves/ devises
- exposure in health care setting
- diabetes
- heart disease
- acquired valvular dysfunction
- mitral valve prolapse with regurgitation
what are the 3 main organisms that cause infective endocarditis
- staphylococci (most common)
- streptococci
- enterococci
what is the most common cause of infective endocarditis
MRSA
what is the most likely organism involved in infective endocarditis in children
strep
what is the most likely organism involved in infective endocarditis following a GI or urinary procedure
enterococci
what is the name of the diagnostic standard for infective endocarditis
modified duke criteria
what type of data is integrated in the modified duke criteria
- clinical
- lab
- micro
- echocardoigraphic
what are the two major criteria that must be met to diagnose endocarditis
- positive blood culture
2. evidence of IE in TTE or TEE
what amount of criteria are needed to get a definite diagnosis of IE
2 major criteria or 1 major and 3 minor or 5 minor criteria
what are the major criteria of diagnosing IE
- positive blood culture
2. evidence of IE in TTE or TEE
what are the minor criteria of diagnosing IE
- predisposing heart condition
- IV drug use
- fever of 104
- vascular phenomenon (emboli)
5 aneurisms - eye spots
- janway lesions (lesions on foot)
what amount of criteria are needed to get a possible diagnosis of IE
1 major and 1 minor criteria
or
3 minor criteria
what are 4 ways the modified duke criteria can reject a diagnosis of IE
- firm alternative diagnosis
- resolution of IE syndrome with antibiotics for less than four days
- no pathologic evidence of IE at surgery or autopsy with antibiotic therapy of less than four days
- does not meet possible criteria requirements
