Endocarditis

Question 1

Strep viridans

Answer 1

Most common overall cause - low virulence so needs damaged valve (like from chronic RHD), results in small vegetations that don’t destroy the valve (subacute endocarditis)

Question 2

Staph aureus

Answer 2

Most common cause in IVDA - high virulence so can affect normal valves (usually tricuspid) and results in large vegetations that can destroy the valves (acute endocarditis)

Question 3

Staph epidermidis

Answer 3

Associated with prosthetic valves

Question 4

Strep bovis

Answer 4

Associated with patients with colorectal carcinoma - so when you see S. bovis ALWAYS check for colon cancer

Question 5

Endocarditis organisms with negative blood cultures

Answer 5

HACEK organisms - Haemophilus, Actinobacillus (Aggregatibacter), Cardiobacterium, Eiknella, Kingella

Question 6

Septic Emboli Signs

Answer 6

Janeway lesions (nontender erythematous lesions on palms/soles)
Osler nodes (tender lesions on fingers/toes)
Splinter hemorrhages in nail bed

Question 7

Nonbacterial thrombi (location, 2 causes)

Answer 7

Usually due to hypercoaguable state or adenocarcinoma

Only mitral valve lines of closure -> mitral regurg

Question 8

Libman-Sacks Endocarditis (cause and location)

Answer 8

Sterile vegetations from SLE, vegetations on BOTH sides (surface and undersurface) of mitral valve -> mitral regurg