Infectious Processes Flashcards
Acute bacterial endocarditis is to Staph aureus as Subacute bacterial endocarditis is to _______
Viridans Strep (usually Strep mutans)
What type of bacterial endocarditis involves a previously healthy valve?
Acute
What are Viridans Strep according to our flowchart?
G+ cocci, catalase -, alpha hemolytic (green/partial), Bile Esculin -, Optochin Resistant
(Viridis is Latin for green)
What are Staph aureus on the flowchart?
G+ cocci, clusters, catalase +, coagulase + (also mannitol salt +)
What are the characteristics of the bug most associated with prosthetic valve endocarditis?
Staph epidermidis
G+ cocci, catalase +, coagulase -, Novobiocin Sensitive
What are the characteristics of the bug most associated with endocarditis in a colon cancer patient?
Strep bovis (a group D Strep, with Enterococcus)
G+ cocci, catalase -, nonhemolytic (gamma)
IV drug users typically get endocarditis involving the _______ valve caused by ________
Tricuspid
Staph aureus/Pseudomonas/Candida
Round white spots on RETINA surrounded by hemorrhage
Roth spots
very TENDER raised nodules on finger pads and toe pads
Osler’s nodes
ow=Ostler
small erythematous lesions on palms and soles
Janeway lesions
Reddish purple lines on nails
Splinter hemorrhages
What is the acronym for the findings of bacterial endocarditis?
FROM JANE
fever, roth spots, osler nodes, murmur, janeway lesion, anemia, nail hemorrhages, emboli
Describe the flow of events in subacute bacterial endocarditis
dmg to valve/exposed subendothelial collagen/thrombotic vegetation (platelets+fibrin)/bacteria colonize vegetation
Patient presents with fever, tender raised nodules on the finger pads, and splinter hemorrhages. Cultures come back negative. Patient has lots of lots of neutrophils around and a left shift. What could be going on?
infection with one of the HACEK bacteria
Describe the characteristics of the HACEK group
all fastidious GNRs
Haemophilus parainfluenza (blood, also choc agar)
Aggregatibacter actinomycetemcomitans
Cardiobacterium hominis
Eikanella corrodens (human bites, bleach smell)
Kingella
What is Libman Sacks Endocarditis?
nonbacterial, associated with SLE
What are the gross findings in endocarditis associated with SLE?
sterile vegetations on BOTH SIDES of valve (usu mitral)
result: mitral regurg
What are the flowchart characteristics of the causative agent of Rheumatic fever?
Strep pyogenes (aka group A Strep)
G+ cocci in chains, catalase - , Beta/complete hemolysis, Bacitraicin sensitive
also pyr +
Rheumatic fever is a progression of a basic pharyngitis in kids due to?
Molecular mimicry
Type II hypersensitivity
Ab vs bacterial M PROTEIN attack self
Complications of a Group A Strep pharyngitis can cause rheumatic fever and/or ?
glomerulonephritis
How do we diagnose rheumatic fever and what do the letters stand for?
Jones criteria
Joints (migratory polyarthritis) O (think of a heart shape for pancarditis) Nodules (subq) Erythema marginatum (rash, red borders) Syndenham Chorea (rapid invol. mvmt)
As part of the Jones criteria, we must have evidence of a previous group A Strep infection. What are the two acceptable methods?
ASO titer
or
Anti-DNAse B titer
What are the top 2 valves involved in Rheumatic fever endocarditis?
Mitral #1
Aortic #2
What is the characteristic finding in the myocardium of a rheumatic fever patient?
Aschoff body
