Endocarditis

Question 1

Infective endocarditis usually arises due to bacteria in the ___1____ and abnormal cardiac __2_____ that facilitates their adherence and growth

Answer 1

1 blood stream

2 endothelium

Question 2

Endocarditis from the mouth due to dental disease or procedures will be caused by

Answer 2

alpha haemolytic viridans streptococci

Question 3

Native and prosthetic valve endocarditis will be caused by

Answer 3

early= staph aureus or epidermis
later= wider range

Question 4

Endocarditis from the gut and perineum due to disease or procedure will be caused by

Answer 4

enterococci e.g. e faecalis

Question 5

Endocarditis from bowel malignancy will be caused by

Answer 5

strep gallolycticus

Question 6

Rare causes of endocarditis?

Answer 6

HACEK group

Question 7

Culture negative endocarditis may be due to

Answer 7

Coxiella brunette, chlamydia species, bartonella species and legionella.

Question 8

What criteria is used to assess likelihood of endocarditis?

Answer 8

Duke’s criteria

Question 9

Some signs and symptoms of endocarditis?

Answer 9

Pyrexia, malaise, clubbing, murmurs, skin lesions e.g. splinter haemorrhages, laneway lesions, roth spots, splenomegaly, haematuria

Question 10

Blood cultures should be done prior to

Answer 10

starting antimicrobial therapy if suspected endocarditis

Question 11

Usually endocarditis is ___1___ sided except in drug users where it is __2__ sided and the __3__ is commonly affected

Answer 11

1 left
2 right
3 tricuspid

Question 12

Empirical treatment for native valve?

Answer 12

Amoxicillin and gentamicin IV

Question 13

Empirical treatment for prosthetic valve?

Answer 13

Vancomycin and gentamicin IV and add in rifampicin

Question 14

Empirical treatment for drug users?

Answer 14

Flucloxacillin IV

Question 15

Treatment for Staph Aureus?

Answer 15

Flucloxacillin Iv

Question 16

Treatment for Viridans strep?

Answer 16

Benzylpenicillin and Gentamicin IV

Question 17

Treatment for enterococci?

Answer 17

Amoxicillin/ vancomycin and gentamicin IV

Question 18

Treatment for staph epidermis?

Answer 18

Vancomycin and gentamicin IV and then add in rifampicin

Question 19

Often antibiotics are given in groups of two too…

Answer 19

achieve synergy (working together)

Question 20

Is it rare to have two separate organisms causing endocarditis?

Answer 20

Yes

Question 21

Endocarditis drug users is most likely

Answer 21

staph a