Endocarditis

Question 1

Risk factors for IE

Answer 1

• Prosthetic heart valves *
• History of infective endocarditis *
• Coexisting conditions (IVDU, HIV, DM, cancer) *
• Intracardiac device
• Structural heart disease
• Unrepaired congenital heart disease
• Rheumatic heart disease
• Hemodialysis
• Indwelling IV line
• Increased age (>60 y/o)
• Recent dental or surgical procedure
• Male sex

Question 2

Risk factors of PVE (prosthetic valve endocarditis)

Answer 2

• Early-onset PVE: within 1 year of implantation (possible contamination during surgery; S. aureus and Coagulase negative staph most common)
• Late-onset PVE: >1
  year from implantation

Question 3

IVDU with IE

Answer 3

• Right-sided IE more common
• Most common bug = S. aureus
• Bacteria contaminate drug or skin contaminated on injection

Question 4

Clinical Presentation of IE

Answer 4

• Fever
• New or worsening murmur
• Bacteremia
• Embolic phenomena and physical exam findings
• ## Mycotic aneurysm