Infective Endocarditis Flashcards
What is infective endocarditis
Infective endocarditis (IE) is an infection of the inner lining of the heart muscle (endocardium) caused by bacteria, fungi, or germs that enter through the bloodstream. IE occurs most frequently in patients with abnormal (leaky or narrow) heart valves, artificial (prosthetic) heart valve or in people who have a pacemaker lead or have had endocarditis before. Approximately 80% of infective endocarditis cases are caused by the bacteria streptococci and staphylococci.
What happens if the infection remains untreated
The endocardium covers the heart valves, and it is these valves which are primarily affected by infective endocarditis. If the infection remains untreated, multiplying bacteria may eventually destroy the valves and result in heart failure. Bacteria may also form small clots (emboli) which move through the blood and block small arteries. These clots may lodge in various parts of the body including the brain and cause serious damage.
Symptoms and signs of Infection endocarditis
Heart murmur not previously present or a changed heart murmur (Presents in 80% of endocarditis patients)
a high temperature
chills
night sweats
headaches
shortness of breath, especially during physical activity
Loss of appetite leading to weight loss
Blood or blood cells in the urine (hematuria)
Small red spots in the conjunctiva of the eyes and fingernails (splinter hemorrhages)
Small painless spots on the palms of the hands or soles of the feet (Janeway lesions)
Pain nodules in the fingertips (Osler nodes)
management of Infective endocarditis
Therefore, early diagnosis and aggressive therapy are critical for successful treatment. Therapeutic measures typically include intravenous infusion of high doses of appropriate antibiotic drugs. Antibiotic therapy is needed for at least six or eight weeks and is provided intravenously for at least 2 weeks and often for the entire treatment duration. The specific drugs or drug combinations used may depend upon the bacterium responsible for the infection and other factors (e.g., bacterial strain resistance to certain antibiotics). The specific antibiotics uses in each patient are selected based on the blood culture results and determining which antibiotics kill the specific bacteria isolated in each patient. Often more than one antibiotic is given together to increase effectiveness. The type of antibiotic needed will be determined in consultation with infectious disease specialists.
