Endocarditis Flashcards
where is the likely focus of infection of streptococcus pneumoniae
pneumonia, meningitis
where is the likely focus of infection of E.coli/Klebsiella/other coliforms
urinary tracy, gut
where is the likely focus of infection of staphylococcus aureus
skin, wound infection
bone/joint infection
what is staph. epidermidis
commonest coagulase -ve staph
infects skin and prosthetic material
what is the pathogenesis of endocarditits
1 - Heart valve damaged
2 - Turbulent blood flow over roughened endothelium
3 - Platelets / fibrin deposited
4 - Bacteraemia
5 - Organisms settle in fibrin/platelet thrombi
6 - microbial vegetation
what happens often with vegetations
they break off and become lodged in a capillary bed causing abscesses or haemorrhage
what are the organism causing endocarditis of native values (highest to lowest likelihood)
Staphylococcus aureus
Viridans streptococci
Enterococcus sp
Staphylococcus epidermidis
what are some atypical organism causing endocarditis
Coxiella burnetii, Chlamydia, Legionella, Mycoplasma
what are the presenting symptoms of acute endocarditis
sepsis
cardiac failure
usually due to staph aureus
what are subacute presenting symptoms
Fever malaise Weight loss Tiredness Breathlessness
what are signs of subacute endocarditis
New or changing heart murmur finger clubbing splinter haemorrhages splenomegaly Roth spots, Janeway lesions, Osler nodes
what is the second step of diagnosing endocarditis and what type is most sensitive
echocardiogram
transoesophageal
organisms that cause prosthetic value endocarditis
staph epidermidis
staph aureus
organisms causing endocarditis in drug users
staph aureus
what valve does IV endocarditis affect
Tricuspid valve (RHS)
