Infective Endocarditis

Question 1

Define Endocarditis:

Answer 1

inflammation of the endocardium (membranes that line the heart valves and chambers)

Question 2

Define Infective Endocarditis:

Answer 2

non-contagious infection of the heart valves (native ot prosthetic) and the endocardium

Question 3

Which valve has the highest frequency of infection ahd highestv morbidity/mortality?

Answer 3

aortic valve

Question 4

Which valve is the most common in IV drg users?

Answer 4

tricupsid valve

Question 5

What are the risk factors for infective endocarditis?

Answer 5

• prosthetic cardiac valve
• history of infective endocarditis
• bacteremia
• IV drug use
• diabetes
• IV catheterization
• colon cancer
• poor dentition
• chronic hemodialysis
• implantable pacemaker
• TPN
• congenital heart disease
• CHD
• heart transplant

Question 6

What are the signs/symptoms of infective endocarditis?

Answer 6

• fever/chills
• cough/dyspnea
• orthopnea
• night sweats
• weight loss
• fatigue/malaise
• TIA, stroke, MI

Question 7

What are the most common organisms respondsible for infective endocarditis?

Answer 7

1. staphylococcs spp. (staph. aureus most common)
2. streptococcus spp.
3. enterococcus spp.

HACEK gram negative organisms

Question 8

What is the modified duke criteria?

Answer 8

diagnostic tool for infective endocarditis, includes major and minor criteria, diagnosis of infective endocarditis includes one of the following:
- 2 major criteria
- 1 major criteria + 3 minor criteria
- 5 minor criteria

Question 9

How many blood cultures are needed before beginning treatment of infective endocarditis?

Answer 9

3

Question 10

What is empiric treatment for native valve infective endocarditis?

Answer 10

ampicillin/sulbactam 3g Q6H + gentamicin 3mg/kg/day divided in 2-3 dose

if allergy: vancomycin + gentamicin + ciprofloxacin