Infective endocarditis Flashcards
What is the most common causative organism of IE?
Staph aureus
Esp in IVDU
What is the most common causative bacteria of IE just after valve surgery?
Staph epidermidis
What are the common causative bacteria of IE?
Staph aureus Staph epidermidis Strep viridians Strep bovis Enterococci Coxiella burnetti
What are some non infective causes of endocarditis?
SLE
Malignancy
What are the biggest risk factors for IE?
IVDU
Prosthetic heart valve
What is the common presentation of IE?
Fever + new murmur= IE until proven otherwise Murmur Fever, night sweats Myalgia, arthralgia Headache SOB Malaise, weight loss, fatigue
What are the features of IE?
FROM JANE Fever Roth spots= retinal haemorrhages Osler's nodes = raised painful lesions on hands and feet Murmur Janeway lesions = non tender erythematous lesions on palms and soles Anaemia Nailbed haemorrhage Emboli
What investigations are done for IE?
FBC, U*Es, LFTs, CRP, ESR Blood cultures Urinalysis ECG CXR Echo
When should blood cultures be taken in IE?
3 samples with 6 hours between
2 samples with 1 hour between if in septic shock
What is sen on ECG with IE?
Wide QRS
Long PR
How is IE diagnosed?
Dukes modified criteria
- 2 major
- 1 major, 3 minor
- 5 minor
What are the Dukes modified criteria?
Major -blood cultures + -endcoardial involvement Minor -Temperature -Immuno features -microbio features -vascular features -predisposing factors
What is the management of IE?
IV antibiotics
Surgery
What empirical antibiotics are started in IE?
Native valve= amoxicillin +/- gentamicin
Prosthetic valve= vancomycin + rifampicin + gentamicin
What are the complications of IE?
Congestive heart failure
Systemic emboli
Mitral valve vegetation
Valvular rupture/fistula
