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Infective Endocarditis (Clinical Presentation (Fever and sweats in someone…
Infective Endocarditis
Definition
= Infection of the endocardium i.e. valves, septum, pacemaker leads, surgical patches
Bad infection, it also travels in blood around the body
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Aetiology
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Strep. viridans - most common cause, gram +ve alpha haemolytic + optochin resistant
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Poor dental hygiene - bacteria in plaque can cause gum disease which can enter the bloodstream after brushing/dental procedure
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Pathophysiology
Damaged endocardium promotes platelet and fibrin deposition which allows organisms to adhere and grow
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Clinical Presentation
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Kidney dysfunction: haematuria, glomerulonephritis
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Investigations
Definite diagnosis from Duke criteria: 2 major, 1 major + 3 minor or 5 minor
Bloods will show raised CRP + ESR, neutrophilia
Minor Criteria
Vascular phenomena e.g. emboli, Janeway lesions
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Echo
Transthoracic: safe, non-invasive, no discomfort however low sensitivity due to poor imaging
Transoesophageal: tube is pushed down throat, uncomfortable, much more sensitive and better at diagnosing
Treatment
Surgery to remove valve - only done when infection cannot be cured with antibiotics or to remove vegetations or infected device
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