Infections Flashcards
Endocarditis is an infection of the endocardium, usually in what part?
Valve leaflets
What are common complications associated with endocarditis?
Stroke (15%) and valve surgery (32%)
Who are at high risk of contracting endocarditis?
IVDU
Hemodialysis
DM
HIV
Immunosuppression
Dental Procedures
Valvular Heart Disease
Endovascular Hardware
Where is it more common for vegetation to occur in endocarditis?
Left side of the heart (mitral or aortic valves) due to more turbulent flow, more O2, and valvular disorders more common
What is the number one bacterial cause of endocarditis?
Staph aureus
What are common bugs that cause endocarditis?
Staph aureus
Strep viridans
Enterococci
What are Osler’s Nodes?
Painful raised red lesions on the hands and feet in endocarditis
What are Janeway lesions?
Non-tender, flat, small red lesions on hands or feet in endocarditis
What are splinter hemorrhages?
Capillary hemorrhages under the fingernails (seen in endocarditis)
What are Roth Spots?
Retinal hemorrhages with pale centers (sign of endocarditis)
What is the work-up for endocarditis?
Blood cultures (2-3 sets from 2 different locations)
Echo (TTE with follow-up TEE if positive or high risk)
When should blood cultures be collected in the work-up of endocarditis?
Before empiric antibiotic
What is the Duke criteria for endocarditis?
2 major
1 major + 3 minor
5 minor
What are the major criteria in the Duke Criteria for diagnosing endocarditis?
Positive blood culture
Evidence of endocardial involvement by ECHO
What are the minor criterion in the Duke Criteria for diagnosing endocarditis?
Predisposition
Fever
Microbiogic evidence
Vascular phenomena (Janeway lesions, emboli, etc.)
ECHO findings
IVDU’s with endocarditis are at higher risk for developing
septic emboli or metastatic infections
Prophylaxis antibiotics for the prevention of high risk patients for endocarditis should be given in these situations
Significant dental work
Invasive respiratory tract procedures
Procedures involving skin or MSK infections
Rheumatic fever is a sequelae of
Strep pharyngitis
Beta hemolytic strep (strep pyogenes) causes
systemic inflammation
What is the Jones criteria?
Criteria for diagnosing acute rheumatic fever
Joints
Heart
Nodules
Erythema Marginatum
Sydenham chorea
What is the criteria for diagnosing rheumatic fever with Jones criteria?
History of strep infection
2 major or 1 major + 2 minor
What is Sydenham chorea?
Random, continuous, involuntary movements
What is erythema marginatum?
Rapidly enlarging ring or crescent shaped macules with central clearing
Who typically is at high risk for myocarditis?
Primarily young, and healthy patients
Kids
Pregnant females
Immunocompromised
