Infective Endocartidis Flashcards
Serves as a site of bacterial attachment during transient bacteremia
Nonbacterial thrombotic endocarditis (nbte)
Uninfected vegetations seen in patients with malignancy and chronic disease
Marantic endocarditis
Where is incidence of endocarditis higher? ICD or permanent pacemaker?
ICD
MC cause of Community acquired native valve endocarditis
Streptococci
MC cause of Health care associated native valve endocarditis
Staphylococcus aureus
MC cause of prosthetic valve endocarditis
(Less than 2 months)
And also in 2-12 months
CoAgulase negative staphylococci
MC cause of prosthetic valve endocarditis
More than 12 months
Streptococci
MC cause of endocarditis in injection drug users
R sided: S aureus
L sided: enterococci
Treatment IE
Streptococci penicillin susceptible strep
S gallolyticus
1) PenG 2-3 mU w4 for 4 weeks
Ceftriaxone 2g single dose X 2 wks
Vancomycin 15 q12 X 4 weeks
+ Gentamicin
Rx enterococci
Penicillin G plus gentamicin both for 4-6 weeks
Ampicillin + gentamicin both for 4-6 weeks
Ampicillin + Ceftriaxone. 6 weeks
Rx staphylococci MSSA native VS prosthetic valves
Nafcillin/Oxacillin/Flucloxacillin 4-6 weeks
Cefazolin
Vancomycin
Prosthetic:
Oxacillin
Gentamicin
Rifampicin
Prophylaxis for endocarditis in HR lesions
Standard - Amoxicillin 2g PO 1 h before procedure Unable - ampicillin 2gIV Pen allergy - clarithro or azithromycin - ceohalexin - clindamycin Pen allergy unable to take meds - cefazolin or Ceftriaxone - clindamycin
HIGH RISK CARDIAC LESIONS for which endocarditis prophylaxis is advised before dental procedures
Prosthetic valves
Prior endocarditis
Unrepaired cyanotic congenital heart disease
Completely repaired congenital heart defects
Valvulopathy after cardiac transplant
Extra cardiac complications of endocarditis
Splenic abscess 3-5
Mycotoxins aneurysm 2-15
Hgh risk echo features
Large vegetations
Valve insufficiency
Paravalvular infection
Ventricular dysfunction
