Intro to CV Infectious Disease - Diebel Flashcards
What are the normal biota of the cardiovascular system?
NOTHING
- privileged site
- should be sterile
What causes damage in disease in cardiovascular infections?
- Growth of organisms
- direct cell lysis
- apoptosis
- autophagy
- Toxins produced by microorganism
- Immune system collateral damage or malfunction
What are the natural host defenses found in the cardiovascular system?
- Leukocytes
- Complement
- Immunoglobulins
- Constant, high pressure flow
What is infectious endocarditis?
Inflammation of the inner lining of the heart (endocardium).
- almost always caused by bacteria
- colonization on heart valve
- living bacterial cells clumped together with platelets and fibrin
- biofilm covering
What valves are most often affected in infectious endocarditis?
Mitral or Aortic Valve
What is the difference between acute and subacute endocarditis?
- Acute:
- hectically febrile (103-104)
- rapidly damages cardiac structures
- seeds infection in distal sites through sepsis
- If untreated –> death
- Subacute:
- Indolent course of infection
- causes structural cardiac damage slowly
- rarely seeds infection at distal sites
- gradually progressive (sx develop more slowly and are less pronounced)
What are common signs and symptoms of infectious endocarditis?
- Fever
- Anemia
- Abnormal heartbeat (murmur)
- Malaise
- Petechiae
- Septic emboli
- Roth’s spots
- Splinter hemorrhages (under fingernails)
- Splenomegaly
- Abdominal pain
What is the most common type of bacteria that causes Acute Endocarditis?
Staph aureus
(sometimes Strep pyogenes)
What is the most common type of bacteria that causes Subacute Endocarditis?
- Streptococcal* species (viridans)
- Enterococcal* species
What valve is most commonly affected in cases of infectious endocarditis and IV drug use?
Tricuspid valve
What are some common portals of entry or primary infection sites that may lead to infectious endocarditis?
- Oral cavity
- Skin
- Upper respiratory tract
What is the gold standard diagnostic test for infectious endocarditis?
Blood culture
What are the 3 potential positive result criteria according to The Duke Criteria?
- 2 major criteria met
- 1 major + 3 minor met
- 5 minor criteria met
What are the two Duke Major Criteria?
- Positive blood culture (x2)
- Evidence of endocardial involvement
What are the five Duke Minor Criteria?
- Predisposition (heart condition or IV drug use)
- Fever above 100.3
- Vascular phenomena (arterial emboli, Janeway lesions, petechiae, etc.)
- Immunological phenomena (Osler’s nodes, Roth’s spots, rheumatoid factor, etc.)
- Microbiological evidence (single positive blood culture, but not meeting major criterion, etc.)
