Endocarditis, Myocarditis & Pericarditis Flashcards
Define sepsis
Bacteria in the blood
Why can blood cultures be unreliable?
Easy contamination - skin contaminants
Strep pneumonia often indicates?
Pneumonia or meningitis
E coli/ Klebsiella/ cloakrooms often indicate?
Urniary tract/ GI infection
Staph aureus often indicates?
Skin/ wound infection
Bone/ joint infection
Endocarditis
Commonest coagulase -ve staph
Often a skin contaminant
Known to infect prosthetic material
Staph epidermidis
Fever = new murmur
Endocarditis until proven otherwise
Majority of people with infective endocarditis patients are from what age group?
> 50 years old
Predisposing factors for infective endocarditis?
Heart valve abnormalities (stenosis, post rheumatic fever, congenital heart disease)
Prosthetic heart valves
IV drug users
Intravascular lines
Brief pathogenesis?
Valve damage, turbulent blood flow, platelet/ fibrin deposition, bacteraemia (dental work?), microbial vegetation, breaking off of the vegetation, this lodges in a capillary bed, abscess or haemorrhage
Infective endocarditis more commonly effects which side of the heat?
Left side of the heart
Infective endocarditis more commonly effects which valves?
mitral and aortic
4 common causative organisms of infective endocarditis?
Staph aureus
Viridans streptococci
Enterococcus sp.
Staph epidermidis
Two classes of atypical causative organisms of infective endocarditis?
Gram -ve
Fungi
2 presenting symptoms of acute endocarditis?
Cardiac failure presentation, severe sepsis
5 subacute presentation of endocarditis?
Fever Malaise Weight loss Breathlessness Tiredness
Clinical signs of subacute infective endocarditis?
Fever, clubbing, new/ changed murmur, splinter haemorrhages, Microscopic haematuria, splenomegaly, Roth spots, Janeway lesions, Oslers nodes
Describe oslers nodes
Sore, red lesions
Describe Janeway lesions
Small, non-tender, red, non-hemorrhagic lesions on palms/ soles of feet
How should blood cultures be taken to diagnose infective endocarditis?
3 sets from different sites at the peak of fever BEFORE any antibiotics
Other diagnostic techniques for infective endocarditis?
U&Es - haematuria
CXR - cardiomegaly
ECG - long PR intervals at regular intervals
Which type of ECHO should be used diagnostically for infective endocarditis?
transoesophageal