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Flashcards in Infective Endicarditis Deck (13)
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Pathophysiology of infective endocarditis?

Becteraemia with bacterial lodging in damaged endocardium, most commonly an infected valve. The valve becomes inflamed, eroded, and a vegetation develops



Dental procedures, invasive investigations


Which bacteria is usually responsible?

Step. Viridans is most common but others such as staph. a and chlamydia may be responsible


How does acute endocarditis present?

Acute febrile Illness, ischeamia in toes and fingers, changing murmurs and valve incompetence


Presentation of subacute endocarditis?

Longer illness, intermittent fever, sweats, malaise, weight loss, splinter haemorrhages (caused by circulating immune complexes), changing murmur, finger clubbing, Roth spots (retinal haemorrhages with pale centres), janeway lesions, café au lait spots


Duke criteria are used for diagnosis, how many need to be met?

Two major, one major and 3 minor or 5 minor


Major criteria include?

+ve blood culture for a causative bacteria in inf endocarditis evidence of vegiatation or new regurgitation on echocardiogram


Minor criteria are?

Predisposing heart problem, persisting fever over 38 degrees, vascular phenomenon (splinter hs), immunological (Roth spots), +ve blood culture for a non assoc bacteria! consistant echo


Investigations include?

Multiple blood cultures from different sites and times, FBC (low Hb high WBC), raised CRP and ESR, echo (vegiatation a or regurg), ECG


If haemodynaiclly unstable where are patients kept



What is the management?

Key is identification of organism and antibiotics against it. Burst guess antibiotics are benzyl penicillin and gentamicin at least 3 weeks IV but therapy as a whole at least 6 weeks


What surgery may have to be done if there is valve damage?

Valve replacement


What is it?

An infection of the endocardium, the layer that which covers the valves and the lining of the cardiac chambers