Infectious Dx: Infectious Bacterial Endocarditis

Question 1

True or False: Infectious endocarditis is often considered uncommon, often treatable disease in dogs typically affecting the mitral and aortic valves.

Answer 1

False, while uncommon it is most often fatal

Question 2

Treatment of bacterial endocarditis includes -?

Answer 2

Long term broad-spectrum antibiotics for 6 to 8 weeks, with the first week of therapy being administered intravenously

Question 3

What echocardiographic findings are required for diagnosis of infectious bacterial endocarditis?
Why might this be seen?

Answer 3

Vegetative valvular lesions and valvular insufficiency (volume overload to the left side of the heart) with distended pulmonary veins, as a result of bacterial adherence to the disrupted endothelial surface of a cardiac valve

Question 4

What are some common bacteria associated with infectious endocarditis?

Answer 4

Staphylococcus, Streptococcus, E. Coli, Bartonella

Question 5

Immune mediated disease is seen commonly in dogs with infectious endocarditis including -?

Answer 5

Polyarthritis and glomerulonephritis

Question 6

What disease presents similarly in smaller breeds, which is also the most common heart disease in dogs?

Answer 6

Myxomatous valvular degeneration

Question 7

What are some common source of bacteremia in dogs?

Answer 7

Diskospondylitis, prostatitis, pneumonia, urinary tract infections, pyoderma, periodontal disease, and long term indwelling catheters

Question 8

What physical exam findings are often associated with aortic involvement with infectious endocarditis?

Answer 8

While murmurs and arrhythmias (ventricular > SVT > 3rd AV block > afib) are commonly auscultated, a diastolic murmur with bounding femoral pulses should be associated with aortic IE

Question 9

True or False: Azithromycin should not be a first-line sole antibiotic treatment for bartonellosis, due to it being the most susceptible for the development of resistance.

Answer 9

True

Question 10

Standard medications for treatment of infectious endocarditis include what drugs, beyond any antimicrobials?

Answer 10

ACE inhibitors, loop diuretics, positive inotropic drugs, and anti-hypertensive therapies as well

Question 11

Death in patients following diagnosis of IE is often associated with -?

Answer 11

Lethal arrhythmias, CHF