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Infective Endocarditis (Clinical Features (Special signs (Immune complex…
Infective Endocarditis
Clinical Features
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Special signs
Immune complex deposition: Roth spots (retina), splinter haemorrhages, vasculitis, microscopic haematuria, Osler's nodes (painful)
Embolic phenomena: Janeway lesions (painless), abscesses in organs
Septic signs e.g. rigors, night sweats
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Management
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Prevention: no current Abx, advise re: good oral hygiene and risks of invasive procedures e.g. dentist/tatoos, Sx of IE
Aetiology
Native valve endocarditis: most commonly due to strep viridans. Other causes: staph aureus, staph epidermidis, enterococci, HACEK (rare)
Prosthetic valve: Staph epidermidis, staph aureus
IV drug user: staph aureus. Other causes: enterococci, streptococci, fungi (candida) and gram -ve rods (psuedomonas)
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Investigations
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Bloods: culture 3 sets from 3 sites, FBC, CRP, UEC, CMP, LFTs, coags, G&S
ECG: long PR, non-specific ST changes
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