INFECTIVE ENDOCARDITIS

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Agents?
Bacteria, fungi, rickettsia, chlamydia
Mortality rate?
25%
Most pts are over what age?
50
More common in men or women?
Men
3 major groups of IE based on host characteristics?
*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?
Pathologic
How can you make a clinical dx of IE?
Duke criteria
Major Duke criteria? (3)
*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)
*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?
2 major or 1 major + 3 minor or 5 minor
Possible IE=?
1 major + 1 minor
OR
3 minor
80% of IE caused by what?
Streptococci and staphylococci
Most cases of IE in IVDU caused by?
S. aureus
IE in NVE mostly caused by?
Strep viridans (50%) and staph aureus
Early PVE caused by?
Introoperative contamination...coagulase-negative staphylococcus