Infective Endocarditis Flashcards
What is the first test you should order to determine the etiologic cause of IE?
Blood culture
What are Osler nodes?
Painful nodules on the palms and soles
What are Janeway lesions?
non-tender flat lesions on palms and soles
What are Roth spots?
Small vegetative emboli to the retina
List some symptoms of IE
Fever New Murmur Vegetation seen on echo Osler node Splinter hemorrhage Janeway lesions Roth spots Conjunctival petechiae Splenomegaly Anemia Hematuria
What 4 organisms (or groups of organisms) are most likely to cause bacterial endocarditis?
Viridans streptococci
Staph aureus
HACEK group
Enterococcus spp
Name the organisms in the HACEK Group
Haemophilis parainfluenzae Actinobacillus Aggregatibacter Cardiobacterium Eikenella Kingella
What are common reasons for negative blood cultures in endocarditis?
Fastidious organisms (hard to grow – Anaerobes, HACEK)
Prior administration of antibiotics
Fungal IE
Non infective endocarditis
What valve is most commonly infected in IVDA IE?
Tricuspid valve
What organism most commonly causes IE in IVDAs?
Staph aureus
When should you start antibiotics when IE is suspected?
Wait until the blood cultures are positive
Definitive Duke Criteria for IE
Microorganisms shown by culture or histology in a vegetation
pathologic lesions (vegetation of intracardiac abscess present)
Major Duke Criteria for iE
Persistently + blood cultures for typical organism
Typical findings on echo
Endocardial damage (new regurgitant murmur)
Serological or cultural evidence of Coxiella burnetti
Minor Duke Criteria for IE
Fever Predisposition Vascular phenomena (embolism, Janeway lesions) Immunologic phenomena Microbiologic
What other test in addition to blood cultures could confirm diagnosis?
Transesophageal Echocardiogram
