Endocarditis and Myocarditis Flashcards
what is the clinical presentation of acute endocarditis
acute onset, high fever/chills
acute endocarditis usually affects previously _ valves and the _ valve is the most affected in IV drug users
normal
tricuspid
vegetations from endocarditis can form what two things
abscesses and septic emboli
classic signs of acute endocarditis
laneway lesions -palms and soles
Roth spots- eyes
osler nodes- finger tips
splinter hemorrhage
**septic emboli that have broken off
acute endocarditis is most commonly due to ?
staph aureus
acute endocarditis: staph aureus
- key/case vignettes
-pathogenesis - diagnosis
-treatment
case vignettes/key clues: fever, malaise, leukocytosis, heart murmur (might not be there in the initial stages)
pathogenesis: forms a fibrin platelet mesh and releases cytolytic toxins
diagnosis: gram stain- gram positive cocci, catalase +, coagulase +
treatment: penicillin and IV vancomycin
acute endocarditis: staph epidermis
-key clues/case vignette
-pathogenesis
-diagnosis
-treatment
key clues: catcher or prosthetic device is inserted
pathogenesis: is apart of the normal flora but will create a biofilm once the skin is interrupted
diagnosis: gram stain- gram positive cocci, catalase +, coagulase negative, novobicin sensitive (will not grow)
treatment: IV vancomycin
acute endocarditis: pseudomonas aeruginosa
- key clues/case vignette
-pathogenesis - diagnosis
-treatment
key clues: blue green pigment, fruity odor, transmission via water sources, raw veggies
pathogenesis: endotoxin LPS and pseudomonas exotoxin A it will ADP ribosylate ELF-2 and inhibit protein synthesis
diagnosis: gram stain- gram negative rod, oxidase positive, aerobic
treatment: antipsuedomonal penicilin and ahminoglycosides
classic signs of Myocarditis
dilation of all 4 chambers
diffuse patchy pallor with foci of hemorrhage
peripheral edema
