Infective Endocarditis Flashcards
What is the most common valve affected as a result of infective endocarditis?
Mitral valve disease
Diagnostic test for infective endocarditis?
Blood culture
Echocardiogram
Empiric Tx for Infective Endocarditis before blood cultures are back?
Native valve –> amox/benzylpenicillin + gent
Prosthetic valve –> vanc + rifampicin + gent (VGR)
Name 3 indications for valvular surgery in infective endocariditis
- Severe valvular incompetence
- Aortic abscess (indicated by prolonged PR interval)
- Infections resistant to antibiotics and antifungals
- Cardiac failure
- Recurrent emboli after treatment (usually septic)
Why is the treatment for endocarditis a long course of IV Abx i.e 6 weeks?
Valves are relatively avascular
What is the criteria used to diagnose infective endocarditis?
Modified Duke’s criteria
Give 3 medical risk factors for infective endocarditis
- Valvular disease
- Previous Infective Endocarditis
- Congenital Heart Disease
- Previous history of rheumatic fever
Give 2 bedside tests you should do in infective endocarditis and why
Urine dipstick - look for haematuria evident of glomerulonephritis
ECG - look for PR interval prolongation in aortic root abscess
SSx of infective endocarditis?
New onset murmur
Splinter haemorrhages (micro emboli and haemorrhage)
Janeway lesions (micro emboli and haemorrhage)
Osler nodes (immune compex deposition)
Roth spots (micro emboli and haemorrhage)
Fatigue, pyrexia, Nausea, SSx of heart failure if severe
Why give rifampicin in prosthetic valve I.E?
Prevents biofilm formation
Why rifampicin cannot be given as monotherapy?
Easy for micro-organism to gain resistance
Give 2 social risk factors for I.E
Poor dentition
IVDU
Give 1 surgical risk factor for I.E
Previous valvular surgery
Poor prognostic factors in I.E?
Staphylococcus aureus infection (see below)
prosthetic valve
culture negative endocarditis (HACEK organisms)
low complement levels
