Endocarditis Flashcards
What is endocarditis?
Infection of the heart valvaes and other endocardial tissue
What is endocarditis growth often referred to?
Vegetation
WHat causes endocarditis?
Trauma turbulence, previously damaged vale where bacteria can attach and can colonize
Endocarditis most commonly happens from hematogenous spread therefore
Results in bacterial adhesions and colonization
What does the fibrin and platelet do?
Prove a protective cover for the bacteria so it can grow and thrive
What is the definition of acute endocarditis?
Severe and rapid clinical course which often normal valves are involved
Which bacteria is usually responsible for acute endocarditis?
Staph. Aureus
What is subacute endocarditis?
Illness often alsts months before being diagnosed and is usually some form of prior valve disease
Usually streptococcal or enteroccocal
What does subacute endocarditis usually follow?
Dental work or procedures
Which bacteria are usually responsible for subacute endocarditis?
Streptococcal or enterococcal
With respect to prosthetic valve endocarditis when is the onset usually?
Can be early or late where it occurs < or > 1 year of surgery
Which organisms are usually responsible for early onset prosthetic valve endocarditis?
Staphylococcal, can also be some gramge negative bacilli or fungal
WHich organisms can cause late onset endocarditis?
Strep generally
Why does prosthetic valve endocarditis generally form?
Because it is very hard to seterilize prosthetic valves to treatment invovles surgery
What are the risk factors of endocarditis?
What is the common etiology (Bacteria) involved in Endocarditis?
Staphylococci
Streptococci
enterococci
Which bacteria may be introduced into the bloodstream via dental or respiratory procedures
Streptococci
Which bacteria is especially known in Staph Aureus?
Especially seen in IV drug use and early prosthetic valve endocarditis
Which bacteria is introduced via GI/GU procedure or from GI/GU
Enterococci
What are the signs and symptoms?
Fever in most cases
Heart murmur (48%) or worsening of old murmur
Fatique weakness, weight los arthralgias, myalgias, nightsweats, headache
What are some uncommon signs and symptoms of endocarditis?
Osler nodes
Janeway lesions
Vascular embolic event
Petechiae
Splinter hemorrhages
What does IV drug use generally lead to?
Right sided endocarditis
Often presents as a pulmonary syndrome
- Fever
- Cough
- Hemoptysis
- Pleuritic chest pain
What are the laboratory changes in endocarditis
What are the blood culture and sensitivity parameters?
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.
What is the Major modified duke criteria for Endocarditis?
Positive blood culture, evidence of endocardial invovlement
What is the Minor modified duke criteria for Endocarditis?
Predisposition for IE, fever, Vascular Phenomenon, immunologic phenomenon, blood culture
What is a definite diagnosis of endocarditis according to modified duke criteria?
What is a possible diagnosis of endocarditis according to modified duke criteria?
