Quiz 5 - Granger - Infective Endocarditis Flashcards
Intermittent bacteremia?
Clearance exceeds entry
Source is local infection
-Skin, lungs, bone, joint
Continuous bacteremia?
Seeding exceeds clearance capacity
What are some predispositions for IE?
Congenital heart disease
Rheumatic heart disease
Prosthetic heart valves and/or heart transplantation
Conditions for bacteremia
-Dental, urological, GI
IV drug abuse
T/F - Bacteria grow w/in fibrin vegetations.
TRUE
How are innate and acquire systems subverted in IE?
Endocardium lacks capillary circulation required for neutrophil access to site
Tell me the Duke criteria for a diagnosis of IE.
Continuous bacteremia
Target lesion on valve, supports, or endocardium
Fever
Heart condition
IV drug user
Emboli phenomena
What papules will exist with IE?
Tender Osler’s nodes
Eccymotic emboilc Janeway lesion - S aureus IE
Conjunctival petechiae - may also be in oral mucosa
—Signs of septic emboli
What are the three bugs associated with IE, listed from most prevalent to least prevalent?
S aureus
Strep viridans and gamma strep spp.
Enterococci
G- bacilli
Fungi
What are clinical complications of IE?
Congestive heart failure
Stroke
Infarcts
Glomerulonephritis
Mycolic aneurysms
Abscesses and osteomyelitis
- Local
- Distant
Prevention of IE?
Prophylaxis prior to procedures
Prophylaxis is indicated if what risk factors are present?
Prosthetic heart valves
Previous IE
Congenital heart diseases
Heart tx w valvulopathies
Tx of IE?
IV therapy
Bacteriocidal regimen
-2,4,6,8 wk tx
T/F - The enigma behind IE is that it is very fatal, yet caused by non-pathogenic bacteria in many cases.
TRUE
Cure rate is high if dx is made early and correct antibiotic regimen is given for the recommended length of time
