Lec 22 Infective Endocarditis Flashcards
Vegetations are a collection of __________.
Platelet, fibrin, bacteria, response of the body
Cause of acute endocarditis
S. aureus, Group B strep
Cause of sub-acute endocarditis
Alpha hemolytic Streptococci, (Streptococcus viridans) or Enterococci
Cause of early endocarditis
Coagulase negative Staphylococci (specifically S. epidermidis)
Cause of late endocarditis
Staphylococci, alpha hemolytic, streptococci
Most common etiologic organism in native valve IE in adults
Streptococci
Early etiologic organism for prosthetic valve IE
Coagulase negative Staphylococci
Late etiologic organism for prosthetic valve IE
Streptococci
Occurs with genitourinary manipulation
Enterococcus
Treatment of enterococcus
penicillin + gentamicin
Characterized by a highly toxic febrile illness, frequent focal metastatic infection and central nervous system complication
COAGULASE-POSITIVE (S. aureus)
Major cause of IE in all populations especially health care associated and in IV drug abuse
COAGULASE-POSITIVE (S. aureus)
Treatment for coagulase-positive S.aureus
Nafcillin/Oxacillin
Major cause of PVE during first year
coagulase-negative (S. epidermidis)
HACEK organisms
Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella
most common gram negative bacillus cause of IE
Pseudomonas aeruginosa
How many major and/or minor criteria are needed for definitive diagnosis of IE (Duke’s)
Two major criteria, OR One major & three minor, OR Five minor criteria
What is needed for the rejection of IE as a diagnosis?
Sustained resolution of symptoms of endocarditis with antibiotic therapy for < 4days
When is cardiac surgery considered?
Patient is not responding to antibiotics or if there is no improvement in the condition after 1 week
