Infective endocarditis Flashcards
What is infective endocarditis?
Infective endocarditis is defined as an inflammation of the endocardium (inner lining of cardiac muscle), as well as the valves or of any indwelling cardiac devices. It is primarily caused by bacteria (over viruses and fungi) and has a myriad of intracardiac and extracardiac complications.
Why is infective endocarditis so important?
What is acute infective endocarditis?
What is subacute infective endocarditis?
What are the complications of infective endocarditis?
What is the most severe form of infective endocarditis?
What is cardiac implantable electronic device related infective endocarditis?
What are the most common valves affected in infective endocarditis?
What is the pathogenesis of infective endocarditis?
What are the predisposing cardiac risk factors which makes a patient at risk of infective endocarditis?
What are the predisposing non- cardiac risk factors which makes a patient at risk of infective endocarditis?
What are the symptoms and signs of infective endocarditis?
What are the atypical presentations of infective endocarditis?
Why is the diagnosis of infective endocarditis challenging?
What are the key points to consider when suspecting infective endocarditis?
What are the microbiology investigations for infective endocarditis?
What imaging investigations are required for suspected infective endocarditis?
What laboratory investigations are done and what do they show?
What are the other investigations that can be carried out?
Which microorganism is most linked with infective endocarditis in intravenous drug users?
Staphylococcus aureus
What are the microorganisms associated with infective endocarditis?
Gram positive in majority of cases.
Staphylococci are most common microorganism group in infective endocarditis.
Staph. Aureus is more prevalent in IVDU users and tends to cause right sided infective endocarditis (tricuspid and pulmonary valves).
Staph. Lugdunensis is rare but associated with a high mortality rate.
Streptococcus gallolyticus (previously called strep bovis) may be associated with underlying colorectal cancer.
Enterococcus faecalis may be associated with genitourinary source but not always.
When would you screen for culture negative infective endocarditis?
What is the minor diagnostic criteria?
How is the diagnosis of infective endocarditis confirmed using the criteria?
What is the management of infective endocarditis?
What is antibiotic therapy and the key principles?
What is the role of outpatient antibiotics?
What is a sign of uncontrolled infection in infective endocarditis?
Persistent fevers and positive blood cultures >7 days after appropriate antibiotic therapy
What is the difference between right sided and left sided infective endocarditis?
Most patients with right–sided infective endocarditis (tricuspid, pulmonary) are typically (not always) medically managed as they are more benign than left-sided infective endocarditis (mitral and aortic).
However, for patients with confirmed cardiac implantable electronic device related endocarditis, complete system extraction is recommended.
What are the lifestyle advice you should give to patients at risk of infective endocarditis?
What is antibiotic prophylaxis?
