Infective endocarditis

Question 1

describe what infective endocarditis is

Answer 1

infection of the endothelium of the heart valves, can be chronic or acute

Question 2

describe the risk factors for infective endocarditis

Answer 2

heart valve abnormality, prosthetic valve, IV drug users, immunocomprimised

Question 3

what are the main causitive organisms of infective endocarditis (4)

Answer 3

staphylococcus aureus(most common cause), viridans streptococci, enterococcus sp, staphylococcus epidermis,

Question 4

what is usually the causitive organism in early prosthetic valve endocarditis

Answer 4

either staphylococcus epidermis or aureus

Question 5

what is usually the causitive organism in IV drug users

Answer 5

staphylococcus aureus

Question 6

what signs always require infective endocarditis investigation

Answer 6

new murmur + a fever

Question 7

what are the acute symptoms of infective endocarditis

Answer 7

sepsis, cardiac failure

Question 8

what are some of the subacute symptoms/signs of infective endocarditis

Answer 8

weight loss, rigors, clubbing, splenomegaly, fever, new murmur

Question 9

what is the main investigation for infective endocarditis

Answer 9

3 sets of blood cultures, taken >12 hours apart

Question 10

what is used to detect atypical organisms in infective endocarditis

Answer 10

if bloods -ve, serology used for atypical

Question 11

what drugs are given to treat subacute infective endocarditis

Answer 11

amoxicillin IV and gentamicin IV

Question 12

what drugs are given to treat acute infective endocarditis

Answer 12

flucloxacillin IV

Question 13

what drugs are given to treat prosthetic or suspected MRSA(multi-resistant staph. aureus) endocarditis

Answer 13

vancomycin IV + gentamicin IV + rifampicin orally

Question 14

how long is the typical antibiotic treatment and what options are there if this fails

Answer 14

4-6 weeks, if not the maybe surgery