Infective Endocarditis

Question 1

What is infective endocarditis?

Answer 1

Microbial infection of the inner lining of the heart (endocardium)

Question 2

What is the term used to describe the classic lesion in infective endocarditis?

Answer 2

Vegetation

Question 3

Which valves may be involve in IE?

Answer 3

1. Aortic
2. Mitral
3. Tricuspid
4. Rarely the Pulmonic

Question 4

What are some of the reasons why there is less if an occurrence of IE in developed countries like the US?

Answer 4

1. Less incidence of Rheumatic heart disease

2. Less concern for risk with Dental surgery or other processes

Question 5

What are some of the reasons why there is an increase in occurrence of IE in developed countries like the US?

Answer 5

1. More Staph as well as fastidious and/or drug resistant organisms
2. More degenerative heart disease in aging population

Question 6

What groups of organism have a virulence factor that make them more likely to adhere and cause IE?

Answer 6

1. Gram Positive Staph
2. Viridians group Strep.
3. Candida species

Question 7

In the US what are the most common predisposing lesions to IE?

Answer 7

DEGENERATIVE LESIONS

• Calcified Annuus of the valve
• Valve nodules
• Mitral Valve Prolapse
• Bicuspid aortic valve

Question 8

What is the most common predisposing lesion to IE in developing countries?

Answer 8

Rheumatic heart disease

Question 9

Incidence of IE in prosthetic valves early <1 year is almost always due to?

Answer 9

Staphlococci

Question 10

Incidence of IE in prosthetic valves late >1 year is almost always due to?

Answer 10

Same organisms as Native valve endocarditis

Question 11

What is very common in IV drug user patients with TV endocarditis?

Answer 11

Pulmonary Emboli

Question 12

At what size is there increased risk of embolization?

Answer 12

If vegetation is more than >10mm

Question 13

How would one test for IE?

Answer 13

Blood cultures, usually the organism is in the blood in persistent amounts

Question 14

What would be the cause of Culture-negative endocarditis?

Answer 14

Previously administered antibiotics

Question 15

What should one do if he/she suspects IE and cultures are negative?

Answer 15

Obtain more cultures

Question 16

Which group of microorganisms are most commonly responsible for IE?

Answer 16

Gram Positive

Question 17

What is the organism most commonly isolated in the USA from IE especially from IE?

Answer 17

Staph Aureus

Question 18

What microrganisms are more commonly seen in Subacute IE?

Answer 18

Viridans group Strep

Question 19

What does Nutritionally variant Strep now referred to as Abiotropha elegans or Granulicatella require for growth

Answer 19

B6

Question 20

What are the associations of Strep Gallolyticus formerly referred to as S bovis?

Answer 20

Frequently associated with Lesions of the large bowel especially malignancies

Question 21

What is the most common cause of early prosthetic valve endocarditis?

Answer 21

Coagulase-negative Staph

Question 22

What is the most common species of Coagulase negative Staph

Answer 22

Staph epidermidis

Question 23

What microorganism is most seen in IV drug users and prosthetic

Answer 23

Pseudomonas Aeruginosa