Infective Endocarditis

Question 1

What is the risk for IV drug users?

Answer 1

Right sided valve issues because of venous return via staph aureus, typically causing tricuspid endocarditis

Question 2

What is the DUke criteria?

Answer 2

BE FIVE PM
BE= major criteria
FIVEPM= minor criteria

Question 3

What is the major crtieria?

Answer 3

BE
B=blood culture 2 separate positive showing microorganisms

E-evidence with ECHOCARDIOGRAM of endocardial involvement with vegetation or new valve regurg

Question 4

What is the minor criteria?

Answer 4

FIVE PM
F=fever over 38 degrees
I= immunological phenomenal like Roth spot, osler’s node and positive rheumatoid
V= vascular phenomena like Janeway lesion
E=echocardiogra minor criteria
P=predisoposing feature
M= microbiological evidence not meeting major crtieria or active infection with organism

Question 5

What are the immunological phenomena in infective endocarditis?

Answer 5

Roth spots
Olser’s nodes
Immune complex-mediated glomerulonephritis
Positive rheumatoid factor

Question 6

What is the vascular phenomena?

Answer 6

Janewy lesion

Septic emboli/infarct/abscess

Conjuctival haemorrage

Splinter haemorrhage

Question 7

What is the criteria for blood cultures in Duke’s?

Answer 7

At least 3 sets taken at different times and sites

Question 8

What are the HACEK organisms?

Answer 8

Organisms in URTI associated with dental brushing or procedures

Haemophilus influenzae
Aggregatibacter
Cardiobacterium
Eikenella
Kingella

Question 9

What organisms causing infective endocarditis causes colorectal cancer?

Answer 9

Streptococcus bovis infection that can cause change in bowel habit and painless rectal bleeding

Question 10

What does prolonged PR indicate?

Answer 10

Aortic root abscess formation, ASO associated with bradycardia

Question 11

How can septic emboli present?

Answer 11

Abdominal pain
Focal neurology due to stroke
Gangrenous fingers

Question 12

What should be tested for blood cultures not growing any organism?

Answer 12

Serological testing for Coxiella and bartonella

Question 13

What is a complication with infective endocarditis?

Answer 13

Peri-valvular abscess which is an indication for valve replacement

Question 14

What are the indications for valve replacement?

Answer 14

Severe valve dysfunction
Heart failure
Resistant microbial
Persistent infection despite antibiotic