Infective endocarditis

Question 1

Name the criteria for IE and how many major/minor factors you need to meet the criteria

Answer 1

Dukes criteria

2 major Or
1 major + 3 minor OR
5 minor

Question 2

What is the pneumonic for dukes criteria

Answer 2

Bacterial Endocarditis (major) FIVE PM (minor)

Question 3

Major dukes criteria

Answer 3

Bacterial cultures positive for typical bacteria on 2 cultures 12 hours apart (need 3 cultures)
Endocardial involvement seen in trans oesophageal echo e.g vegetation or new murmur

Question 4

Minor dukes criteria

Answer 4

Fever >38 degrees C
Immunology phenomena - Roth spots, odlers nodes
Vascular phenomena - janeway lesions, emboli, haematuria, intracranial haemorrhage
Echo findings not meeting major criteria
Predisposition - Prosthetic heart valve, valve disease, IVDU
Microbiology not meeting major criteria

Question 5

Empirical treatment for native valve infection

Answer 5

Amoxicillin + gentamicin

Question 6

Treatment for native valve staphylococcal infection

Answer 6

Flucloxacillin

Question 7

Treatment for prosthetic valve staphylococcal infection

Answer 7

Flucloxacillin + gentamicin + rifampicin

Question 8

Empirical treatment for prosthetic valve infection

Answer 8

Vancomycin + gentamicin + rifampicin