Endocarditis

Question 1

Dukes criteria: Major

Answer 1

Question 2

Dukes criteria: Minor

Answer 2

Question 3

Early surgery (native valve IE). Early valve surgery is recommended, or should be considered, for native left-sided IE in the following scenarios:

Answer 3

1. Valve dysfunction resulting in symptoms or signs of heart failure.
2. IE caused by fungi or highly resistant organisms.
3. IE complicated by heart block, annular abscess, or destructive perforating lesions.
4. Persistent infection (bacteremia or fever) lasting >5-7 days after the start of appropriate antimicrobial therapy, assuming other sources of infection or fever have been excluded.
5. Recurrent emboli or persistent/enlarging vegetations despite appropriate antimicrobial therapy.

Question 4

Early surgery (prosthetic valve IE). Early valve surgery is recommended, or should be considered, for prosthetic vale IE in the following scenarios:

Answer 4

1. Symptoms or signs of heart failure resulting from valve dehiscence, intracardiac fistula, or severe prosthetic dysfunction.
2. Persistent bacteremia >5-7 days after the start of appropriate antimicrobial therapy.
3. Prosthetic valve IE complicated by heart block, annular abscess, or destructive perforating lesions.
4. Prosthetic valve IE caused by fungi or highly resistant organisms.
5. Recurrent emboli despite appropriate antimicrobial therapy.

Question 5

High-risk procedures in which high-risk patients should receive antibiotic prophylaxis.

Answer 5