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Agents?
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Bacteria, fungi, rickettsia, chlamydia
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Mortality rate?
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25%
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Most pts are over what age?
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50
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More common in men or women?
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Men
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3 major groups of IE based on host characteristics?
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*Native valve endocarditis
*prosthetic valve endocarditis; further divided into early (frist month after surg and late) *endocarditis in IV drug users |
Gold standard for dx is?
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Pathologic
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How can you make a clinical dx of IE?
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Duke criteria
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Major Duke criteria? (3)
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*Persistently + blood cultures with microorganisms consistent with IE (>2 + cultures separated by at least 12 hrs or more OR >3 cultures at least 1 hr apart OR 70% of blood culutres + if four or more are drawn
*single blood culutre + for Coxiella burnetii or IgG antibody titer >1:800 *Echocardiographic evdience of endocardial involvement |
Minor Duke criteria? (5)
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*Predisposing heart condition
*fever *vascular phenomena (arterial emobli, septic pulmonary emboli, mycotic aneurysm, Janeway lesions) *Immunologic pheonoma (glomerulonephritis, Osler nodes, Roth spots, rheumatoid factor) *+ blood cultures not meeting major criteria |
Definitive dx of IE= what combos of criteria?
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2 major or 1 major + 3 minor or 5 minor
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Possible IE=?
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1 major + 1 minor
OR 3 minor |
80% of IE caused by what?
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Streptococci and staphylococci
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Most cases of IE in IVDU caused by?
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S. aureus
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IE in NVE mostly caused by?
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Strep viridans (50%) and staph aureus
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Early PVE caused by?
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Introoperative contamination...coagulase-negative staphylococcus
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