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INFECTIVE ENDOCARDITIS - Coggle Diagram
INFECTIVE ENDOCARDITIS
SLO1 : Describe the types of IE
CLASSIFICATION
ACUTE
HIGH VIRULENT
S. AUREUS
HARD TO CURE BY ANTIBIOTICS
FORM NECROTIZING // ULCERATIVE // INVASIVE VALVULAR INFECTIONS
REQUIRE SURGERY
INFECT NORMAL HEART VALVES
SUB-ACUTE
LOW VIRULENT
S. VIRIDANS
LESS DESTRUCTIVE INFECTIONS
INFECT ABNORMAL DEFORMED HEARTS
TREATED BY ANTIBIOTIC THERAPY
DEPENDS ON :-
SEVERITY
VIRULENCE OF MICROORGANISM
DEFINITION
MICROBIAL INFECTION OF HEART VALVES / MURAL ENDOCARDIUM
RISK FACTORS
RECENT SURGERY
PACEMAKER IMPLANTATION
VALVE REPLACEMENT
LONG TERM HAEMODIALYSIS
SYSTEMIC SEPSIS
NOSOCOMIAL INFECTION
POOR DENTAL HYGIENE
IV & URINE CATHETERS
IV DRUG MISABUSE
CLINICAL MANIFESTATIONS
COMMON ONES
FEVER // CHILLS // MALAISE
LOSS OF WEIGHT
ANEMIAS
MURMURS
SPECIAL ONES
JANEWAY LESIONS
SMALL ERYTHEMATOUS // MACULAR // NONTENDER LESIONS
PALMS // SOLES
PAINLESS
D/T SEPTIC EMBOLISM
OSLER NODES
PAINFUL
SMALL // TENDER SUBCUTANEOUS NODULES
PULP OF DIGITS // PROXIMAL IN FINGERS
ROTH SPOTS
OVER RETINAL HAERMORRHAGES W/ PALE CENTERS
SPLINTER HAEMORRHAGE
TINY BLOOD SPOT
UNDERNEATH NAIL
SLO2 : Describe the aetiology & pathogenesis of IE
AETIOLOGY
Microorganism fr normal flora
Bloodstream
To survive :-
microorganism must be resistant to killing action of ab
GRAM +VE
hve thick layer of rigid micropeptide -- to protects its cell membrane
cause endocarditis
Via :-
DENTAL PROCEDURES
INSTRUMENTATION ON URT
AGGRESSIVE CHEWING
S. VIRIDANS
STAPHYLOCOCCI
ENTER BLOODSTREAM VIA :-
INSERTION OF CANNULAE
SIMPLE VENIPUNCTURE
DIRECTLY IMPLANTED FR SURGEONS SKIN VIA PUNCTURED GLOVES
S. FAECALIS
Present in = LARGE INTESTINES
May cause URINARY TRACT INFECTION
ENTER BLOODSTREAM VIA :-
CYTOCOPY
CAUSATIVE AGENTS
DENTAL PROCEDURES
S. VIRIDANS
HAEMOPHILLUS
EIKENELLA
KINGELLA
CARDIOBACTERIUM
ACTINOBACILLUS
PROSTHETIC VALVES
S.EPIDERMIS
GRAM -VE BACILLI
FUNGI
GI PROCEDURES
ENTEROCOCCI
S. BOVIS
NOSOCOMIAL
GRAM -VE
CANDIDA
S. AUREUS
PATHOGENESIS
BACTERIAL ENTRY
BACTERIAL ADHERANCE
BACTERIAL PROLIFERATION
VEGETATION FORMATION
Endocardial injury
Adherence of platelets & fibrin
Microorganism fr outside enter bloodstream
via :-
Transient bacterial fr oral // mucosal // skin surface
Distance source of focal infection
These microorganism cause infection
PLATELET FIBRIN NIDUS
Continuous microbial growth
activated COAGULATION SYSTEM
2 more items...
SLO3 : Describe morphology & diagnosis of IE
MORPHOLOGY
VEGETATIONS AT HEART VALVES
COMMON SITES AT :-
AORTIC VALVES
BY S.AUREUS
MITRAL VALVES
BY S. VIRIDANS
MAY ERODE MYOCARDIUM --- FORM RING ABSCESS
VEGETATIONS
EMBOLIZATION
ABSCESS
SEPTIC INFARCTS // MYCOTIC ANEURYSM
FIBRIN // INFLAMMATORY CELLS // BACTERIA
MAY INVOLVE > 1 VALVE
DIAGNOSIS
DUKE CRITERIA
2 MAJOR
1 MAJOR + 3 MINOR
5 MINOR
PATHOLOGICALLY :-
EMBOLUS
INTRACARDIAC ABSCESS
VEGETATIONS
CLINICALLY :-
MAJOR
BLOOD CULTURE
+VE FOR ANY ORGANISM
ECHOCARDIOGRAHIC IDENTIFICATION OF VALVE
IMPLANT RELATED ABSCESS
PARTIAL SEPARATION OF ARTIFICIAL VALVE
VALVULAR REGURGITATION
MINOR
IV DRUG USE
FEVER
HEART LESION
VASCULAR LESION
EMBOLI
SEPTIC INFARCTS
SPLINTER HAEMORRHAGES
MYCOTIC ANEURYSM
ARTERIAL HYPERTENSION
JANEWAY LESION
MICROBIOLOGIC EVIDENCE
ECHOCARDIOGRAPHIC FINDINGS
IMMUNOLOGICAL PHENOMENA
GLOMERUONEPHRITIS
OSLER NODES
ROTH SPOTS
RHEUMATOID FACTORS
SLO4 : Descibe the complications of IE
COMPLICATIONS
SEPTIC EMBOLI
CEREBRAL / RENAL INFARCTS
MYOCARDITIS
ENLARGEMENT OF VEGETATION
CHORDAE TENDINAE RUPTURE
DEATH
PERICARDITIS
VALVULAR IMCOMPETENCE
MYCOTIC ANEURYSM
STROKE
VEGETATIVE ENDOCARDITIS
RHD
SMALL // WARTY VEGETATIONS
AT LINES OF CLOSURE OF VALVE LEAFLETS
IE
AT VALVE CUSP -- EXTEND TO CHORDAE TENDINAE
LARGE // IRREGULAR MASS
NBTE
SMALL // BLAND VEGETATIONS
AT LINES OF CLOSURE
LSE
EITHER / BOTH VALVE LEAFLETS
SMALL // MEDIUM SIZED VEGETATION