Infective Endocarditis Flashcards
Infective endocarditis - definition
is an infection of the _____________
—usually of 1 or more ___________;
endocardial surfaces of the heart
cardiac valves
Agents of Infective Endocarditis
_______ streptococci
_________,________
Staphylococci
S._______,_________
Gram negative bacilli
•____________(IV drug users)
Viridans
Enterococci, Streptococcus bovis
aureus; epidermidis
Pseudomonas aeruginosa
Agents of Infective Endocarditis
Other GNB
_______ group of organisms;
________,___________,________,_________,________,__________
HACEK
Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae,
Risk factors
_____ conditions are considered to increase a patient’s risk of developing IE
Cardiac
Risk factors
Cardiac conditions are considered to increase a patient’s risk of developing IE:
Valvular heart disease with ______ or _______.
Valve __________.
Previous _________
———— cardiomyopathy
stenosis or regurgitation
replacement
IE
Hypertrophic
Risk factors
Cardiac conditions are considered to increase a patient’s risk of developing IE:
__________________ heart disease, including surgically corrected or palliated structural conditions
Others:____________ and invasive vascular procedures.
Structural congenital
recreational drug abuse
Pathogenesis of Cardiac abnormalities, such as congenital valvular diseases (that lead to turbulence in blood flow)
Damage to the endothelial surface results in the deposition of platelets and fibrin.
Bacteria transiently gain access to the bloodstream - this can occur after an innocuous procedure such as brushing the teeth
Pathogenesis of IE
Cardiac abnormalities, such as ________ diseases (that lead to turbulence in blood flow)
Damage to the _______ results in the _________ of _______ and ______
Bacteria _______ gain access to the bloodstream - this can occur after an innocuous procedure such as _______
congenital valvular
endothelial surface
deposition of platelets and fibrin.
transiently; brushing the teeth
Pathogenesis
After alteration of the __________, the organisms may _______ and then _____ the damaged cardiac endothelial cell surface.
After colonization, the surface will ______________________________________
This protective environment is favorable to ______________
capillary endothelial cells
stick to; colonize
rapidly be covered with a protective layer of fibrin and platelets.
further bacterial multiplication.
Pathogenesis of IE
This web of platelets, fibrin, inflammatory cells, and entrapped organisms is called a ________
The resulting ________ ultimately _______________ at a slow but constant rate.
vegetation
vegetations ; seed bacteria into the blood
The primary causes of infective endocarditis are the __________, comprising several species
These organisms are ________ of the _______, often gaining entrance to the bloodstream as a result of _______,___________, and _____________
viridans streptococci
normal inhabitants
oral cavity
gingivitis, periodontitis, or dental manipulation.
Clinical features of IE
Fever
New or changed heart murmur Fatigue
Aching joints and muscles Night sweats
Shortness of breath
Chest pain
LOL
Investigations
Blood cultures:
Should be taken ______ to _______________
At least _____ sets of blood cultures should be taken at different times within ________ prior to commencement of empirical therapy.
prior to starting treatment in all cases
two; one hour
Investigations
Subculture on blood agar
______ haemolysis
________ optochin test
Bile ____luble
Alpha
Negative
inso
Treatment
Antibiotic susceptibility testing
Useful antibiotics: ________,______,________
Penicillin, Erythromycin, Clindamycin
