Intravascular Infection

Question 1

Presence of bacteria in the blood stream is called what?

Answer 1

Bacteremia

Question 2

What two categories of bacteremia are there?

Answer 2

1-Transient (clearance exceeds entry)

2-Continuous (Seeding exceeds clearance)

Question 3

What are three kinda of endovascular infections?

Answer 3

1-Infective endocarditis
2-Infected thrombus (septic thrombophlebitis)
3-Mycotic aneurysm (arterial wall infection)

Question 4

How does infective endocarditis form?

Answer 4

• Turbulent blood flow
• Endothelial cell activation
• Fibrin and plate deposition
• Bacteria invade and grow in the vegetations

Question 5

What characteristic of valves, chordae and papillary inhibit neutrophil access to the infection?

Answer 5

lack of capillary circulation

Question 6

What are some of the duke criteria for infective endocarditis?

Answer 6

• Continuous bacteremia
• Lesion on valve or endocardium
• Fever

*sometimes depositions of antigen antibody complexes cause red bumps (tender osler’s nodes, Janeway lesions, spots on retina, conjunctival petechiae (bleeding))

Question 7

What are the common organisms that cause infective endocarditis?

Answer 7

• Staphylococci (Gram (+) ,s aureus)
• Streptococci (Gram (+) , viridians, gamma strep)
• enterococci
• gram negative bacilli
• fungi

Question 8

The most likely bacteremia to cause IE are organisms found where?

Answer 8

The oral cavity (S. mutans (G+), S bovis (G+))

Question 9

What are high risk factors for IE?

Answer 9

• Prosthetic heart valves
• Previous IE
• Congenital heart disease
• Valvulopathy

Question 10

Prophylactic antibiotics are typically used for prevention, however, how is IE usually treated?

Answer 10

• Intravenous bactericidal regimen for 2-8 weeks

- surgery