INFECTIVE ENDOCARDITIS Flashcards
What is an infective Endocarditis?
infection of endocardium surface of the heart chambers and valves
What causes Infective Endocarditis?
Bacteria enters bloodstream, travel to the heart and damage the tissue
Usually due to improper dental procedures, catheters or illegal IV drug use
Most common bacteria is Strep. Viridans
What are the presenting symptoms of Infective Endocarditis?
Chills/Fever
Night sweats, malaise, fatigue
Headache
What are the physical signs that show up with infective endocarditis?
Joint pain (arthralgia)
Shortness of breath
Heart murmur
Petechiae (non-specific finding of tiny, circular non-raised patches on the skin or mucosa due to under layer bleed)
Subungual (splinter) haemorrhages - dark red linear lesions in the nail bed
Osler Node - tender subcutaneous nodules usually found on the distal pads of the digit
Janeway lesion - non tender maculae on the palms and soles
Roth spots - retinal haemorrhages with small, clear centres; rare and observed in only 5% of patients
What are the risk factors of Infective Endocarditis?
History of infectious endocarditis
Artificial or damaged heart valves
Implanted heart device
Age >60
Which investigations would you do?
ECG - prolonged PR interval, non-specific ST/T wave abnormalities
ECHOCARDIOGRAM - valvular, mobile vegetations (abnormal growth)
BLOOD TESTS - FBC = normocytic anaemia and leukocytosis; Blood Cultures = Bacteraemia or Fungaemia
What is the Duke Diagnostic Criteria?
Criteria for diagnosing Infective Endocarditis
2 major criteria
1 major and 3 mood criteria
5 minor criteria
What do you use to treat infective endocarditis?
High dose IV anti-bacterial
Amoxcillin and Gentamicin
Run the course for 4-6wks
When is surgery an option in treating Infective Endocarditis?
If infection is persistent or if caused by fungal infection
