Microbio - Infective endocarditis Flashcards
What is infective endocarditis?
Infection of the innermost layer of the heart - usually valves
Which valves are most often affected?
Mitral and aortic (LHS)
Tricuspid in IVDU - bc they are injecting the bacteria and first side of <3 it comes to is RHS
What are 2 ways infective endocarditis can present?
Acute and subacute (over weeks- months - more signs o/e)
RFs of infective endocarditis
- Bacteraemia (long-term lines, IVDU, poor dentition)
- Abnormal valves (prosthetic valves, rheumatic heart disease)
Which pathogens are often responsible for acute infective endocarditis?
Strep pyogenes, Staph aureus (IVDU), CoNS - coagulated negative staph- (prosthetic valves)
Which pathogens are often responsible for subacute infective endocarditis?
Staph epidermis, Strep viridans
Infective endocarditis presentation
- Fever
- New heart murmur (often changes day to day)
Infective endocarditis presentation specific to subacute
- Embolic phenomena: Janeway lesions, splinter haemorrhages, splenomegaly, septic abscesses, microemboli
- Immune phenomena: Roth spots, Osler’s nodes, haematuria
What is this sign?
(Small, non tender nodules on palms and soles)
Janeway lesions
What is this sign?
(Small, painful nodules on figners and toes)
Osler’s nodes
What is this sign?
(small lines underneath nail)
Splinter haemorrhages
What is this sign?
(Small spots on retina seen on fundoscopy)
Roth spots
What criteria is used to assess infective endocarditis?
Duke’s criteria
What are major points (2) and minor (5)?
Major
- Positive blood cultures growing typical organisms
- New regurgitant murmur/vegetation on echo
Minor
- Risk factor
- Fever
- Embolic phenomena
- Immune phenomena
- Positive blood cultures growing other organism
How many major/minor points do you need to diagnose Infective endocarditis?
- 2 major
- 1 major + 3 minor
- 5 minor
