INFECTIVE ENDOCARDITIS Flashcards
IE cause
- Bacterial entry from mouth, skin/ intravenous, GI tract (strep)
- Bacterial adherence to damaged endothelium
- Bacterial proliferation, neutrophil and macrophage infiltration
- Vegetation formation
IE diagnosis
Splinter haemorrhages under nails
Very unwell - fever
Heart murmur
embolic phenomena
IE tx
4+ weeks of bactericidal tx
Combination of drugs
IE effects
Cardiac valve damage - replacement needed
Risk of death
Cardiac pts that arent at risk of IE
Coronary artery bypass grafting
Angioplasty and stent
Hypokinetic cardiac muscle (following MI)
Implanted pacemaker
Implanted defib
Dental procedures that cause risk of bacteremia
xLA
Perio
Gingival surgery
Implants
Restorations if matrix bands used
Antibiotic prophylaxis before invasive dental tx
3g amoxicillin 1 hour before
Dental pt at risk of IE - what should dentist do?
improve OH efforts; diet, OHI, high F toothpaste
Remove areas of dental sepsis; unrestorable carious teeth, teeth causing infection
What guidelines provide controversy in anaphylactic prophylaxis?
European and US guidelines (effective) vs NICE guidlines (ineffective)
Pt at highest risk of IE
Previous endocarditis
valve replacement surgery
congenital heart defects
SDCEP guidance for pt at risk
Pt discussion
advise of general OH measures
antibiotic regime decided by pt and doctor
dental procedures to cover
Informed consent of antiobitic prophylaxis must discuss?
Consequences of ABP and NO ABP
Who makes the decision for antibiotic prophylaxis?
pt and doctor
communicated with dentist in writing
