Infective Endocarditis Flashcards

1
Q

steps to development of infection

A
  • valve surface altered
  • deposition of platelets and fibrin
  • bacteria bind to NBTE, colonize
  • build-up occurs, more fibrin, more bacteria
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2
Q

3 organisms that commonly cause acute endocarditis

A
  • S. aureus
  • S. pneumoniae
  • S. pyogenes
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3
Q

2 organisms that commonly cause subacute endocarditis

A
  • S. viridans

- HACEK

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4
Q

organisms that cause prosthetic valve endocarditis

A
  • early (60 days) - Streptococci
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5
Q

most common organism causing endocarditis in IVDU

A
  • S. aureus
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6
Q

virulence factors favoring colonization

A
  • dextran production: retards antimicrobial therapy

- FimA: surface adhesion protein, mediates attachment to platelet-fibrin molecules

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7
Q

lab characteristics of S. aureus

A
  • coagulase +
  • catalase +
  • beta hemolytic
  • mannitol salt +
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8
Q

characteristics of Abiotrophia spp.

A
  • requires L-cysteine or pyridoxal vitamin B6
  • NF of URT, urogenital tract, and GI
  • seen in subacute endocarditis
  • prone to systemic embolization
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9
Q

characteristics of group D strep

A
  • grows in 6.5% NaCl
  • bile esculin positive
  • PYR positive
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10
Q

characteristics of S. mutans

A
  • associated with cavities

- bile -esculin positive

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11
Q

characteristics of S. bovis

A
  • NF of GI tract
  • does not grow in 6.5% NaCl
  • associated with GI lesions and colon cancer
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12
Q

HACEK organisms

A
  • Haemophilus parainfluenzae
  • Aggregatibacter
  • Cardiobacterium hominus
  • Eikenella corrodens
  • Kingella kingae
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13
Q

presentation of HACEK

A
  • granular growth in broth
  • large friable vegetations
  • frequent emboli
  • development of CHF
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14
Q

difference between Haemophilus parainfluenzae and influenzae

A
  • parainfluenzae grows on blood and chocolate agar

- influenzae only grows on chocolate

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15
Q

characteristics of aggregatibacter

A
  • most common HACEK infection
  • associated with periodontal disease
  • significant embolization
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16
Q

characteristics of cardiobacterium hominus

A
  • associated with periodontal disease
  • typically absence of fever
  • large vegetations, large vessel emboli
17
Q

characteristics of eikenella

A
  • smells like bleach
  • pitting on agar
  • common in IVDU, especially with amphetamines
18
Q

characteristics of kingella

A
  • arthritis seen in children
19
Q

Duke criteria for definite IE

A
  • 2 major
  • 1 major, 3 minor
  • 5 minor
20
Q

Duke criteria for possible IE

A
  • 1 major and 1 minor

- 3 minor

21
Q

Major criteria

A
  • positive blood culture

- evidence of endocardial involvement

22
Q

Minor Duke criteria

A
  • predisposing conditions
  • fever > 100.4
  • vascular phenoma: mycotic aneurysm, conjunctival hemorrhages, Janeway lesions
  • Immunologic phenomena: Oslers nodes, Roth spots
  • Microbiological evidence
  • echo findings
23
Q

additional lab findings associated with IE

A
  • elevated rheumatoid factor titers