Infective Endocarditis Flashcards
What are the predisposing risk factors or IE?
- Congenital heart disease
- Rheumatic heart disease
- IV drug use
- Degenerative valve disease (age)
- Prosthetic valves
Which aetiological agents causing IE originate from the oral cavity, skin and URT?
Strep. viridans
Staph. aureus
HACEK organisms
Which aetiological agents causing IE originate from the GIT?
Strep. agalactiae
If Strep agalactiae is found to cause IE, what other conditions should one look for in the body?
GIT polyps and colon Ca
Which aetiological agents causing IE originate from the genitourinary tract?
Enterococci
Which aetiological agents causing IE originate from an IV catheter or IV drug use?
Staph. aureus
Candida
When should one suspect IE (5 presentations)?
- Fever + new regurgitant murmur
- Fever + prosthetic valves
- Fever + Strep. viridans/ Staph. aureus/ enterococcus bacteraemia
- Fever + IV drug use
- Fever + embolic phenomena ( stroke, absent pulse)
What is one set of blood cultures?
2 culture bottles, each from different veins
What are the reasons for culture negative IE?
Previous exposure to AB
Difficult-to-culture organisms
What is the empiric treatment of IE?
IV Penicillin
+ Gentamycin
+ Cloxacillin if Staph aureus is suspected
Which patients are at risk of severe morbidity or death?
Prosthetic valves
Prior IE
Congenital heart defects
Post cardiac transplant
What are the indications for IE prophylaxis
- Cardiac conditions
- Dental procedures
- Respiratory tract procedures
