Endocarditis Flashcards
What is commonly affected in infective endocarditis?
The heart valves
What are risk factors for infective endocarditis?
Previous rheumatic heart disease
Congenital heart disease
Age-related valvular degeneration
Prosthetic heart valve
PWIDs
Intravascular lines
Septicaemia
What organism is most commonly responsible for infective endocarditis?
Staph. aureus
What organism causes sub-acute infective endocarditis in those with pre-damaged heart valves?
Strep. viridans
What organism is often responsible for infective endocarditis in those with prosthetic valves?
Staph. epidermidis
What organisms are associated with infective endocarditis in PWIDs?
Candida
Staph. aureus
Usually affects the right-sided valves (especially the tricuspid valve).
What are atypical causes of infective endocarditis?
Coxiella burneti (linked to farming)
HACEK bacteria (linked to poor dental hygiene)
Brucella (linked to goats)
Fungi (seen in immunocompromised patients)
What are roth spots?
Non-specific red spots on the retina.
What are Janeway lesions?
Non-tender, small, erythematous or nodular lesions on the palms or soles due to septic emboli.
What are Osler nodes?
Painful, red, lesions on the palms or soles caused by immune complex deposition.
How is infective endocarditis investigated?
3 sets of blood cultures
Echocardiogram (will have vegetations)
Serology (may look for atypicals if blood cultures are negative)
How is staph. aureus infective endocarditis treated?
IV flucloxacillin
How is strep. viridans infective endocarditis treated?
IV benzylpenicillin and gentamicin
How is staph. epidermidis infective endocarditis treated?
IV vancomycin, IV gentamicin and rifampicin PO (for 3-5 days)
