Infective endoarditis

Question 1

MCC of acute IE

Answer 1

Staph aureus

Question 2

MCC of subacute IE

Answer 2

1. Strep viridans
2. E. Faecalis

Least -HACEK -2%

Question 3

Prosthetic valve endocarditis

Answer 3

Early -CoNS
Staph aureus
Corynebacterium

Question 4

Viridans Strep endocarditis Rx

Answer 4

2-4 wks IV Ben pen+ 2 weeks IV gentamicin
or
Ceftriaxone 2gm daily for 4 weeks

Question 5

Enterococcal endocarditis

Answer 5

6 weeks Ben pen/Amox + 2weeks Gent

Question 6

Staph endocarditis

Answer 6

MSSA - 4-6 weeks IV Fluclox/ 1st gen Cephalosporin

MRSA - Vanc 4-6 weeks

Question 7

Tricuspid valve endocarditis

Answer 7

2 weeks IV Fluclox and gentamicin, 4 weeks if complicated(lung involvement)

Question 8

Culture negative endocarditis

Answer 8

Ceftriaxone 3-4 wk+ gentamicin

Q fever IE - Doxy+HCQ (12-18months) +Rifampicin

Question 9

Indications for surgery in IE

Answer 9

Development of HF
Paravalvular extension
Uncontrolled infection -Positive culture despite >10d, resistant organisms
Recurrent embolic events despite antibiotics

Question 10

Malignancies presenting with PUO

Answer 10

Lymphoma, Leukemia, RCC, hepatoma, atrial myxoma, metastatic carcinoma with necrotic secondaries