Endocarditis

Question 1

Risk factors for infective endocarditis? (6)

Answer 1

Abnormal valves (aortic-mitral)
IV drug abuse (tricuspid)
Prosthetic valves
Organ transplantation
Recent surgery
Skin infection

Question 2

Bacteria which cause endocarditis? (4)

Answer 2

Strep viridans
Staph aureus (most common)
Staph epidermidis
HACEK bacteria

Question 3

Criteria used for diagnosis?

Answer 3

Modified Duke criteria

Question 4

What combination of clinical signs means that it should be considered infective endocarditis until proven otherwise?

Answer 4

Fever + new onset murmur

Question 5

Septic signs associated with infective endocarditis?

Answer 5

Fever, rigors, night sweats, weight loss

Question 6

What are Roth spots?

Answer 6

Retinal haemorrhages with pale centre

Question 7

Lesions which are pathognomonic of IE? (2)

Answer 7

Oslers nodes- painful infarcts on pulp of fingers/toes

Janeway lesions- painless macules on palms/soles

Question 8

Specific investigations in suspected IE? (2)

Answer 8

Blood cultures- three sets, different times, different sites at peak of fever

Echocardiogram

Question 9

Which type of echo is best?

Answer 9

Trans-oesophageal

Question 10

Non-infective causes of endocarditis? (2)

Answer 10

Libman-Sacks endocarditis in SLE

Malignancy