Bugs and drugs day
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Risk factors IE | Prosthetic heart valves, stress, cancer, SLE, Dental hygiene, DM, HIV, IVDU, Hemodialysis
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| Acute endocarditis timeline | <6 weeks
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| Chronic endocarditis | >3 mo
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| Clinical findings IE | *fever constitutional, abdo pain, murmur, stroke like symptoms
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| Physical exam | Vitals Hands: clubbing, splinter hemorrhages, vasculitic embolic Roth spots, conjunctival hemorrahted JVP Murmurs, rubs, Flui overload
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| Eye findings | Roth spot Conjunctival hemorrhages
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| Osler's nodes | Painful, erythematous lesions on feet
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| Janeway lesions | Painless lesions on palms and soles of feet (from emboli)
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| Bugs infecting native valve | Viridans strep Staph aureus HACEK Bartonella Fungal
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| HACEK organisms | Hemophilus parainfluenza Actinobacillus Cardiobacterium Eikenella Kingella
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| Prosthetic valves | Coagulase negative staph staph aureus GNB, Fungus
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| IDVU organisms IVDU | MRSA, pseudomonas, GNB
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| Most common valves to get infected | Mitral>aortic>tricuspid>pulmonic
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| Criteria to diagnose IE | Duke's criteria (2 major OR 1 major+3 minor OR 5 minor)
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| Blood culture of Dukes criteria (major) | blood culture -by bacteria known to cause -3 blood cultures 12 h apart
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| Endocardial criteria (major) | Endocardial involvement -echo -valvular regurg
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| 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
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| Treatment Acute | abx ASAP to minimize (staph aureus usually)
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| Treatment Subacute (4-5mo) | can delay tx until C and S
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| Treatment Native valve | Cloxacillin, amp, gent?
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| IVDU treatment | Vanco and gent
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| Prosthetic valve treatment | Vanco and gent
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