Infective endocarditis

Question 1

Strep and enterococcus organisms associated with infective endocarditis

Answer 1

Question 2

Indications for Surgery in Infective Endocarditis

Answer 2

Question 3

Duke Criteria for Diagnosis of Infective Endocarditis

Answer 3

Question 4

Antibiotic prophylaxis (for endocarditis): Dental Procedures

Answer 4

Most dental-procedure bacteraemias are caused by viridans group strep
When indicated, prophylaxis should be:

1. Amoxy/ampicillin 2g PO 1 hour before procedure or IV 15 - 30min before procedure
   
   • if hypersensitive can use:
2. Cephalexin 2g PO 1 hour before procedure or Cephazolin 2g IV within 15-30min before procedure
   
   • if immediate hypersensitivity can use:
3. Clindamycin 600mg PO 1 hour before procedure or IV over 20min within 60min of procedure

Question 5

Causes of Culture Negative Endocarditis

Answer 5

• Most common: ABx prior to culure with strep
• Other: Bartonella, Q fever, psittacosis, legionella, brucella, tropheryma whipplei (often diagnosed on serology)