Infective Conditions Flashcards
What are the clinical features of infective endocarditis?
Fever, Chills, Fatigue, lassitude (lack of energy), new murmurs (or changes in existing murmurs), features due to microemboli - Oslers nodes and Janeway lesions
Glomerulonephritis in later stages
Splinter haemorrhages in the nails
Roth spots - haemorrhages in the retina (with a white center)
What are the features of microemboli?
Subungual haemorrhage (bleeding in nail bed) Janeway lesions (erythematous non-tender lesions in the palms and soles of feet) Osler nodes (Nodes in the pulps of digits) Roth spots (retinal haemorrhages)
What are the 2 main bacteria that causes infective endocarditis?
Staphylococci and Streptococci
What does vegetations contain?
Fibrin, inflammatory cells, granulation tissue and micro-organisms
What are Janeway lesions?
Erythematous non-tender lesions in the palms and soles of feet
What are Osler’s nodes?
Nodes in the pulps of digits
What does Marantic Endocarditis mean?
Non-infective endocarditis
What is myxoid degeneration?
A degenerative process in which connective tissues become replaced by gelatinous or mucoid substance.
What are Aschoff bodies?
Aschoff bodies are nodules found in the hearts of individuals with rheumatic fever.
What are the indications for surgery in infective endocarditis?
- Heart failure
- Uncontrolled infections: Fungal endocarditis, persistent bacteraemia, unstable infected prosthetic valve
- Valvular obstruction
- Myocardial abscess
- Prevention of embolic events; repeated emboli
Define xanthelasmata. What is it indicative of and what else to look out for if present?
Xanthelasmata are soft yellowish plaques periorbitally and on the medial aspect of the eyelids associated with hyperlipidaemia.
What are the findings of blood test for Infective Endocarditis?
Normochromic, Normocytic anaemia
Neutrophilia
High ESR/CRP
What will ECG show in Infective Endocarditis?
Prolonged PR interval
What is the treatment for Infective Endocarditis?
If penicillin allergic?
If there are prosthetic valves?
Amoxicillin and gentamicin.
IF penicillin allergic, Vancomycin and gentamicin.
IF prosthetic valves: Vancomycin and gentamicin and Rifampicin
What is Libman-Sacks endocarditis?
Which valve is most commonly involved?
It is a form of non-bacterial endocarditis associated with Systemic lupus erythematosus.
The Mitral valve is most commonly involved.
