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11 Cards in this Set
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- Back
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What is endocarditis?
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Inflammation of the endothelial surface of the heart, usually on a previous damaged aortic or mitral valve
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What is needed for endocarditis to develop? (5)
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Bacteremia (absolute requirement)
Turbulent blood flow (normal around damaged valve or prosthesis) Fibrin-platelet aggregates on endocardium (low pressure side) Adherence of organisms to endocardium Colonization of endocardium |
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Why can't the body deal with endocarditis on its own?
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The valves are basically avascular and everything is quickly washed away, so hard for WBCs to have any action
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What are the most common bacteria that invade?
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S. aureus
S. epidermidis (coagulative negative Staph) usually on prosthetic valve S. viridans (and other a-hemolytics) Pneumococcus GAS, GBS E. faecalis E. faecium |
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Why do gram negatives generally not cause endocarditis?
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Don't adhere as well
The most common is Pseudomonas, which happens in drug users who mix the drug with water which contains Pseudomonas |
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In IV drug users, what is the most common offending organism?
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S. aureus 95% of the time
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What are the two clinical manifestations of endocarditis? Which organisms cause which type?
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Subacute - S. viridans
Acute - S. aureus |
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What are some specific signs of endocarditis?
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Petechiae on arms, legs, and conjunctiva
Splinter hemorrhages in nails Osler's nodes |
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How do you diagnose endocarditis?
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Consistent positive blood cultures
Transesophageal echo |
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How do you treat?
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Depends on bug, some require two drugs
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Which bugs require two drugs to treat endocarditis?
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Enterococcus and Pseudomonas
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