Endocarditis

Question 1

What is endocarditis?

Answer 1

Infection of the heart valvaes and other endocardial tissue

Question 2

What is endocarditis growth often referred to?

Answer 2

Vegetation

Question 3

WHat causes endocarditis?

Answer 3

Trauma turbulence, previously damaged vale where bacteria can attach and can colonize

Question 4

Endocarditis most commonly happens from hematogenous spread therefore

Answer 4

Results in bacterial adhesions and colonization

Question 5

What does the fibrin and platelet do?

Answer 5

Prove a protective cover for the bacteria so it can grow and thrive

Question 6

What is the definition of acute endocarditis?

Answer 6

Severe and rapid clinical course which often normal valves are involved

Question 7

Which bacteria is usually responsible for acute endocarditis?

Answer 7

Staph. Aureus

Question 8

What is subacute endocarditis?

Answer 8

Illness often alsts months before being diagnosed and is usually some form of prior valve disease

Usually streptococcal or enteroccocal

Question 9

What does subacute endocarditis usually follow?

Answer 9

Dental work or procedures

Question 10

Which bacteria are usually responsible for subacute endocarditis?

Answer 10

Streptococcal or enterococcal

Question 11

With respect to prosthetic valve endocarditis when is the onset usually?

Answer 11

Can be early or late where it occurs < or > 1 year of surgery

Question 12

Which organisms are usually responsible for early onset prosthetic valve endocarditis?

Answer 12

Staphylococcal, can also be some gramge negative bacilli or fungal

Question 13

WHich organisms can cause late onset endocarditis?

Answer 13

Strep generally

Question 14

Why does prosthetic valve endocarditis generally form?

Answer 14

Because it is very hard to seterilize prosthetic valves to treatment invovles surgery

Question 15

What are the risk factors of endocarditis?

Answer 15

Question 16

What is the common etiology (Bacteria) involved in Endocarditis?

Answer 16

Staphylococci
Streptococci
enterococci

Question 17

Which bacteria may be introduced into the bloodstream via dental or respiratory procedures

Answer 17

Streptococci

Question 18

Which bacteria is especially known in Staph Aureus?

Answer 18

Especially seen in IV drug use and early prosthetic valve endocarditis

Question 19

Which bacteria is introduced via GI/GU procedure or from GI/GU

Answer 19

Enterococci

Question 20

What are the signs and symptoms?

Answer 20

Fever in most cases
Heart murmur (48%) or worsening of old murmur

Fatique weakness, weight los arthralgias, myalgias, nightsweats, headache

Question 21

What are some uncommon signs and symptoms of endocarditis?

Answer 21

Osler nodes
Janeway lesions
Vascular embolic event
Petechiae
Splinter hemorrhages

Question 22

What does IV drug use generally lead to?

Answer 22

Right sided endocarditis

Often presents as a pulmonary syndrome
- Fever
- Cough
- Hemoptysis
- Pleuritic chest pain

Question 23

What are the laboratory changes in endocarditis

Answer 23

Question 24

What are the blood culture and sensitivity parameters?

Answer 24

Get shredding of bacteria from vegetation

Obtain 3 samples at different times or sites

May be negative due to previous antibiotic therapy or difficult to culture organisms.

Question 25

What is the Major modified duke criteria for Endocarditis?

Answer 25

Positive blood culture, evidence of endocardial invovlement

Question 26

What is the Minor modified duke criteria for Endocarditis?

Answer 26

Predisposition for IE, fever, Vascular Phenomenon, immunologic phenomenon, blood culture

Question 27

What is a definite diagnosis of endocarditis according to modified duke criteria?

Answer 27

Question 28

What is a possible diagnosis of endocarditis according to modified duke criteria?

Answer 28