Infective Endocarditis Flashcards

1
Q

give some risk factors for IE

A
Males
Incidence increases with age
IVDU
poor dental hygiene and dental procedures
structural heart disease
HIV
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2
Q

define IE

A

infection of the endocardium and its related structures including the cardiac valves and chorae teninae.

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3
Q

what is the most common cause of IE, and how does it enter the body

A

Staph aureus

through the skin or through IV/central lines

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4
Q

what is the second most common cause of IE and how does it enter the body

A

strep viridians

commensal of the mouth, pharynx and URT

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5
Q

what is the most common cause of subacute IE

A

strep viridians

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6
Q

what is strep bovis most associated with and what patient group gets it

A

carcinoma of the colon

the elderly

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7
Q

what organism is associated with early prosthetic valve iE and can result from post op wound infection

A

s. epidermis

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8
Q

give some non-infective causes of endocarditis

A

SLE
physical trauma
metastatic lung, GI and pancreatic cancer
chronic infection eg. TB

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9
Q

how does acute IE normally present

A

swinging pyrexia and rigors with few clinical stigmata

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10
Q

gives some signs of IE seen on the hands

A

splinter haemorrhages
oslers nodes
janeway lesions
clubbing

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11
Q

how does IE present

A

pyrexia
+
constitutional symptoms - malaise, fatigue, anorexia, weight loss

+/- embolic phenomena

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12
Q

what are some examination findings you might see in IE

A

new or worsening murmur

Roth’s spots in the eye

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13
Q

how do you take blood cultures in IE

A

3 sets of blood cultures
10ml sample from diffferent peripheral sites
at least 1 hr apart

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14
Q

what Duke criteria are positive for IE

A

2 major
2 major + 3 minor
5 minor

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15
Q

what scoring system is used in IE

A

Duke criteria

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16
Q

what antibiotics are used in those with native valves (+ penicillin allergic version)

A

Amoxicillin + gentamicin

Penicillin allergic:
vancomycin + gentamicin + ciprofloxacin

17
Q

how long do you treat IE for

A

IV abx for 4-6 weeks

18
Q

what antibiotics are used in those with prosthetic valves

A

Vancomycin + gentamicin + clindamycin

19
Q

what are the two most common complications of IE

A

Heart failure

neurological impairment