Infective Endocarditis

Question 1

Where is the infection in IE?

Answer 1

endocardium - usually valve

Question 2

Pathophysiology of IE

Answer 2

Valvular colonisation
Septic emboli

Question 3

Which valves are affected in IE?

Answer 3

Mitral and aortic
IVDU - Tricuspid

Question 4

Most common bacterial pathogens in acute IE

Answer 4

Strep A (pyogenes) - most common
Staph aureus - IVDU
CoNS - prosthetic valves

Question 5

Most common bacterial pathogens in subacute IE

Answer 5

Staph epidermidis
Strep viridans
HACEK

Question 6

IE Sx

Answer 6

Fever
FLAWS
new murmur
Subacute - embolic and immune phenomena

Question 7

Ix for IE

Answer 7

Cultures
Echo
Modified Duke’s criteria - BE TIMER

Question 8

Criteria for diagnosing IE

Answer 8

Clinical or Pathological criteria
Clinical - Duke’s (BE TIMER)
Pathological

Question 9

IE Tx

Answer 9

IV ABx for 4-6 weeks
Surgical debridement if necessary

Question 10

IE ABx choices

Answer 10

Acute - fluclox
Subacute - benpen + gent
Prosthetic valve: vanc + gent + rifampicin (6weeks)