Infective Endocarditis

Question 1

What is IE?

Answer 1

Cardiac valves develop vegetarians composed of bacteria and platelet-fibrin thrombus

Question 2

What are the risk factors for IE?

Answer 2

Cardiac disease -> subacute: Prosthetic valves, degen valvulpathy, VSD, PDA, CoA, Rheumatic fever

Normal valves -> acute: dental, post-op wounds, IVDU (tricuspid valve), immunocompromised incl diabetes

Question 3

What are some non infective causes of IE?

Answer 3

SLE

marantic

Question 4

What are some culture positive causes of IE?

Answer 4

S. viridans (35%)

s. bovis, s.aureus, s. epidermis, enterococci, psuedomonas

Question 5

What are some culture negative causes of IE?

Answer 5

Haemophilus 
Actinobacillus 
Cardiobacterium 
Coxiella
Chlamydia

Question 6

What are some clinical features of IE? (sepsis)

Answer 6

Fever, rigors
Night sweats
Weight loss
Anaemia 
Splenomegaly 
Clubbing

Question 7

What are some cardiac clinical features of IE?

Answer 7

New/changing murmur - often MR, sometimes AR
AV block
LVF

Question 8

What are some embolic phenomena of IE?

Answer 8

Abscesses in brain, heart, kidney, spleen, gut and lung

Janeway lesions

Question 9

What clinical features can result from immune complex deposition in IE?

Answer 9

Haematuria due to GN
Vasculitis
Roth spot 
Splinter haemorrhages 
Osler nodes

Question 10

What are roth spots?

Answer 10

Boat shaped retinal haemorrhages with pale centre

Question 11

What are janeway lesions?

Answer 11

Painless palmar macule

Question 12

What are oslers nodes?

Answer 12

Painful, purple papule on finger pulp

Question 13

What criteria can be used to diagnose IE?

Answer 13

Dukes

Question 14

What are the major criteria in dukes classification?

Answer 14

positive blood culture

endocardium involved which can be seen on echo or if there is a new murmur

Question 15

What are the minor criteria in dukes?

Answer 15

Predisposition
Fever >38
Emboli
Immune phenomenon