ID - Endocarditis

Question 0

What are the 2 major Duke criteria?

Answer 0

1. 2 positive blood cultures for typical IE organisms

2. Abnormal echo

Question 1

How many of the Duke criteria must be met to Dx infective endocarditis?

Answer 1

2 major OR 1 major + 3 minor OR 5 minor

Question 2

What are typical IE organisms?

Answer 2

S. aureus; Strep. viridans, bovis, enterococci; Gram(-) rods; Candida; or HACEK organisms

Question 3

What are the HACEK organisms?

Answer 3

Haemophilus
Actinobacillus
Cardiobacterium 
Eikenella
Kingella

Question 4

What are echo findings indicative of IE (3)?

Answer 4

Intracardiac mass/vegetation, abscess, or new prosthetic valve dehiscence/regurg

Question 5

What are the 5 minor Duke criteria?

Answer 5

1. Fever
2. Risk factors
3. Vascular findings
4. Immunological findings
5. Blood culture (+) not meeting major criteria

Question 6

What are the immunologic findings in IE?

Answer 6

Roth spots, Osler’s nodes, or glomerulonephritis

Question 7

What are Osler’s nodes?

Answer 7

Painful, pea-shaped lesions

Question 8

What is the best empiric Tx for IE?

Answer 8

Vanc + Gentamicin x 4-6 wks.

Question 9

Which cardiac defects require IE ppx before certain procedures?

Answer 9

Prosthetic valves, unrepaired cyanosic heart dz, previous IE, and transplant recipients w/ valve dz

Question 10

Which procedures require antibiotic ppx for IE?

Answer 10

Dental procedures that cause bleeding, respi tract surgery, and surgery of infected skin

Question 11

What is the appropriate antibiotic for ppx before dental procedures that cause bleeding?

Answer 11

Amoxicillin