Infective endocarditis

Question 1

Contraindications to OPAT therapy?

Answer 1

IE caused by highly
difficult-to-treat microorganisms
# liver cirrhosis (Child–
Pugh B or C)
# severe CNS emboli,
# untreated large extracardiac abscesses
# heart valve
complications
# other severe conditions requiring
surgery
# severe post-surgical complications
# PWID-related IE

Question 2

T/F:

If IE is complicated by embolic stroke , thrombolytic therapy is indicated?

Answer 2

F

in embolic stroke, mechanical thrombectomy may be
considered

Thrombolytic therapy is not recommended in embolic
stroke due to IE.

Question 3

What is the only situation were TTE is sufficient to diagnose IE?

Answer 3

isolated right-sided
native valve IE with good quality TTE examination and
unequivocal findings.

Question 4

What are the main indications for surgery in Right side IE?

Answer 4

1-persistent bacteraemia after 1 week of appropriate antibiotic

2- Right ventricular dysfunction secondary to acute severe
tricuspid regurgitation non-responsive to diuretics.

3- Persistent vegetation with respiratory insufficiency
requiring ventilatory support after recurrent pulmonary
emboli.

4- Large residual tricuspid vegetations (>20 mm) after
recurrent septic pulmonary emboli.

5- Patients with simultaneous involvement of left-heart
structures