Infective endocarditis Flashcards
define infective endocarditis?
infection of the heart valves
what is the most common organism causing infective endocarditis?
Staphylococcus aureus
especially in IV drug users
what are other common causes of infective endocarditis?
o + Staphylococcus epidermidis causes endocarditis following prosthetic valve surgery.
o + Streptococcus Viridans associated with poor dental hygiene
o Streptococcus bovis most commonly linked to colorectal cancer
o Coxiella burnetti is associated with farm animals
pathophysiology of infective endocarditis?
- vegetations form when organisms deposit on heart valves during a period of bacteraemia
- the vegetations destroy valve leaflets
which heart valve is most commonly affected in normal people?
mitral
which heart valve is most commonly affected in IVDU?
tricuspid
risk factors for infective endocarditis?
o Rheumatic valve disease o Prosthetic valves o Congenital heart defects o IV drug users o Recent piercings
recognise the presenting symptoms of infective endocarditis?
- Fever with sweats/chills/rigors
- Malaise
- Arthralgia
- Myalgia
- Confusion
- Skin lesions
signs of infective endocarditis?
• Pyrexia • Tachycardia • Signs of anaemia • Clubbing • New regurgitant murmur o Janeway lesions o Osler's nodes o Splinter haemorrhages
what is the gold standard investigation for infective endocarditis?
• Blood Culture
what can be used to diagnose infective endocarditis?
• Duke’s Classification
management plan for infective endocarditis?
• On clinical suspicion = EMPIRICAL TREATMENT o Benzylpenicillin o Gentamicin • Streptococci o Benzylpenicillin o Gentamicin • Staphylococci o Flucloxacillin/vancomycin o Rifampicin o Gentamicin • Enterococci o Ampicillin o Gentamicin
when might surgery be indicated?
o Valves are severely incompetent
o Aortic abscess
o Infections resistant to antibiotics
o Congestive cardiac failure
prognosis of infective endocarditis?
• FATAL if untreated
