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ID Endocarditis

Bugs and drugs day

QuestionAnswer
Risk factors IE Prosthetic heart valves, stress, cancer, SLE, Dental hygiene, DM, HIV, IVDU, Hemodialysis
Acute endocarditis timeline <6 weeks
Chronic endocarditis >3 mo
Clinical findings IE *fever constitutional, abdo pain, murmur, stroke like symptoms
Physical exam Vitals Hands: clubbing, splinter hemorrhages, vasculitic embolic Roth spots, conjunctival hemorrahted JVP Murmurs, rubs, Flui overload
Eye findings Roth spot Conjunctival hemorrhages
Osler's nodes Painful, erythematous lesions on feet
Janeway lesions Painless lesions on palms and soles of feet (from emboli)
Bugs infecting native valve Viridans strep Staph aureus HACEK Bartonella Fungal
HACEK organisms Hemophilus parainfluenza Actinobacillus Cardiobacterium Eikenella Kingella
Prosthetic valves Coagulase negative staph staph aureus GNB, Fungus
IDVU organisms IVDU MRSA, pseudomonas, GNB
Most common valves to get infected Mitral>aortic>tricuspid>pulmonic
Criteria to diagnose IE Duke's criteria (2 major OR 1 major+3 minor OR 5 minor)
Blood culture of Dukes criteria (major) blood culture -by bacteria known to cause -3 blood cultures 12 h apart
Endocardial criteria (major) Endocardial involvement -echo -valvular regurg
Minor criteria -IVDU -Fever -embolization -Janeway, lesions, -GN -Oslers nodes -Roths spots -positive RF -Positive blood culture from bug that doesn't normally cause IE -Echo that doesnt quite meet criteria
Treatment Acute abx ASAP to minimize (staph aureus usually)
Treatment Subacute (4-5mo) can delay tx until C and S
Treatment Native valve Cloxacillin, amp, gent?
IVDU treatment Vanco and gent
Prosthetic valve treatment Vanco and gent
Created by: baby_manatee
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