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CR - Cardiovascular Infections (iii) (peripheral vasc infections (types…
CR - Cardiovascular Infections (iii)
pericarditis
inflamm of pericardium
often with pericardial effusion
chest pain, fever, pericardial rub
causes
often viral (coxsackie, influenza, adenovirus)
staph
strep
TB
Myocarditis
inflamm of heart muscle due to infection
usually viral (coxsackie B, influenza)
C diphtheriae
fever, unexplained HF, arrhythmias
unusual in industrialised world
Cardiac device infections
i.e. pacemakers + defibrillators
increasing importance as pop ages
2% get infected in 1st 5 yrs
local cellulitis, discharge, pain, BSI, endocarditis
Dx
clinical
culture: blood, pus, excised device
Tx
wks of antibiotics
best = source control (i.e. remove device) - if not relapses common
peripheral vasc infections
should be considered when patient post-op
presence of graft (e.g. AAA repair) -> Dx + Tx harder
patients often elderly with underling CV/systemic conditions (e.g. IHD, DM)
man cause = skin flora (e.g. S epidermidis, cam be S aureus)
if in groin often enteric flora (e.g. E coli, P aerugninosa)
types
superficial (e.g. SSI)
deep (involves graft)
associated with systemic infection (e.g. BSI)
challenging Tx: antibiotics +/- source control