Endocarditis Flashcards
biggest risk factor for endocarditis
previous episode
valve most commonly affected?
mitral
(affected by rheumatic valve disease)
tricuspid affected in IV drug users
other risk factors?
prosthetic valve any valve abnormality congenital heart defects IV drug use IV lines
most common causative organism overall?
staph aureus
cause in IV drug users?
staph aureus
cause in people with prosthetic valves or indwelling lines?
staph epidermidis
cause after dental surgery?
strep viridans
non-infective causes?
SLE (libman-sacks endocarditis)
malignancy (marantic endocarditis)
non-bacterial infective causes?
coxiella burnetti
bartonella
brucells
HACEK organisms
how is endocarditis diagnosed?
3 sets of blood cultures (2/3 must be +ve)
- tested via MALDI TOF
ECHO (transoesophageal 1st line, transthoracic if confirmation needed)
serology done if blood cultures done but still suspicious (shows atypical organisms)
how does endocarditis present?
general infective symptoms
new or changing murmur
can have heart failure and hypotension
splinter haemorrhages
roth spots (retinal haemorrhages)
janeway lesions (nodular haemorrhagic lesions on palms and soles)
oslers nodes (red painful lesions in palms and soles)
can have microscopic haematuria and finger clubbing
general management?
IV antibiotics for 6 weeks
native valve management?
amoxicillin + gentamicin
prosthetic valve management?
vancomycin + gentamicin + rifampicin
management if IV drug user?
flucloxacillin (as probs staph aureus)
