Endocarditis Flashcards

1
Q

What is meant by bacteraemia?

A

Presence of bacteria in the bloodstream

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2
Q

What temperature are blood cultures kept at?

A

37’C

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3
Q

The presence of bacteraemia is diagnostic of endocarditis. True/False?

A

False

Just indicates that there is infection somewhere in the body, or that samples may be contaminated

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4
Q

What is the commonest coagulase -ve Staph organism?

A

Staph epidermidis

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5
Q

What does Staph epidermidis commonly contaminate?

A

Skin

Prosthetic material

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6
Q

What is infective endocarditis?

A

Infection of the heart valves

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7
Q

What are the commonest factors that predispose to endocarditis?

A
Rheumatic disease
Congenital abnormalities
IV drug users
Calcification/sclerosis
Prosthesis/intravascular lines
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8
Q

What is the general pathogenesis of endocarditis?

A

Damaged heart valves produce turbulent flow over irritated endothelium, causing platelet/fibrin deposition upon which bacteria settle, producing vegetation over the valve

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9
Q

Which organism is the most common cause of native valve endocarditis?

A

Staph aureus

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10
Q

Which organism is the 2nd commonest cause of native valve endocarditis?

A

Strep viridans

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11
Q

Name some atypical organisms that cause endocarditis

A

Coxiella burnetti
Brucella
Gram -ve organisms
Fungi

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12
Q

What are some symptoms of acute endocarditis?

A
Breathlessness
Fever
Tiredness
Malaise
Weight loss
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13
Q

What are some signs of endocarditis?

A
New/louder murmur
Clubbing
Splinter haemorrhage
Splenomegaly
Roth spots, Janeway lesions, Osler nodes
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14
Q

What are roth spots?

A

Retinal haemorrhages

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15
Q

What are Janeway lesions?

A

Nodular haemorrhagic lesions on palms and soles

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16
Q

What are Osler nodes?

A

Painful red lesions on palms and soles

17
Q

How many blood cultures are taken for diagnosis of endocarditis?

A

3 sets

18
Q

If 3 blood cultures are taken and only 1 comes back positive, what might have been the cause?

A

Contamination

19
Q

Transthoracic echo is more effective than transoesophageal echo. True/False?

A

False

20
Q

What organisms are usually responsible for prosthetic valve endocarditis?

A

Staph aureus

Staph epidermidis

21
Q

Endocarditis in IV drug users predominately affects which side of the heart?

A

Right side (tricuspid valve)

22
Q

How does Staph aureus endocarditis produce pneumonia?

A

Vegetation lodges in pulmonary circulation, causing inflammation, infection and abscess

23
Q

Which antibiotics are given for native valve endocarditis?

A

Amoxicillin IV

Gentamicin IV

24
Q

Which antibiotics are given for prosthetic valve endocarditis?

A

Vancomycin IV

Gentamicin IV

25
Q

Which antibiotic is given for IV drug user endocarditis?

A

Flucloxacillin IV

26
Q

Which antibiotics are given for MRSA endocarditis?

A

Vancomycin IV

Gentamicin IV

27
Q

Which antibiotics are given for Strep viridans endocarditis?

A

Penicillin IV

Gentamicin IV

28
Q

Which antibiotics are given for Enterococcus endocarditis?

A

Amoxicillin/Vancomycin IV

Gentamicin IV

29
Q

Which antibiotics are given for Staph epidermidis endocarditis?

A

Vancomycin IV

Gentamicin IV

30
Q

How long are IV antibiotics usually given for?

A

4-6 weeks