infective endocarditis

Question 1

risk factors of infective endocarditis

Answer 1

IV drug use
structural heart pathology
chronic kidney disease
immunocompromised
history of infective endocarditis

Question 2

causes of infective endocarditis

Answer 2

staph aureus (most common)
strep viridans
enterococcus faecalis
rarer: pseudomonas, HACEK or fungi

Question 3

presentation of infective endocarditis

Answer 3

fever
fatigue
night sweats
muscle aches
anorexia

Question 4

examination findings in infective endocarditis

Answer 4

new or changing murmur
splinter haemorrhages
petechiae
janeway lesions (painless red flat macules on palms of hands and feet)
osler’s nodes (tender red/purple nodules on pads of fingers and toes)
roth spots (haemorrhages on retina)
splenomegaly
finger clubbing

Question 5

investigations in infective endocarditis

Answer 5

blood cultures
echocardiogram (TOE)
specialist imagine for prosthetic valves: 18F-FDG PET/CT, SPECT-CT

Question 6

criteria for infective endocarditis

Answer 6

modified duke criteria

Question 7

management of infective endocarditis

Answer 7

IV broad spectrum abx
- 4 weeks with native
- 6 weeks for prosthetic valve
surgery

Question 8

what valve is most commonly affected in IV drug users with infective endocarditis

Answer 8

tricuspid valve