Infective endocarditis: Difference between revisions
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[[image:iendocarditis.jpg|right|thumb|300px|This is an ultrasound (I think) of an infective endocarditis (I think). The lumpy bit is a vegetation (I think).]] | |||
===Definition=== | ===Definition=== | ||
Infection of the heart valves. | |||
===Epidemiology=== | ===Epidemiology=== | ||
[[image: | [[image:rareimportant.jpg]] About 1 in 25,000 [[incidence]] rate. | ||
===Pathophysiology=== | ===Pathophysiology=== | ||
Since the valves do not have their own blood supply, the [[immune]] system can't get [[white cells]] to the valves, making them susceptable to bacterial infection. | |||
There are two main types: | |||
*'''Acute''' - usually caused by ''[[Staphylococcus]] epidermidis'', comes on over a few days/weeks. | |||
*'''Subacute''' - usually caused by [[Streptococcus viridans]], and comes on over weeks. | |||
===Risk Factors=== | ===Risk Factors=== | ||
*Prosthetic heart valve. | |||
*Recent dental work. | |||
*Injecting [[drugs]] - can lead to [[staph]] infection from skin. | |||
*Previous [[rheumatic fever]] - can cause damage to valves, making it easier for [[bacteria]] to stick on. | |||
There are others, specially anything causing heart shape problems, weird [[murmurs]] or valve damage. | |||
===Clinical Features=== | ===Clinical Features=== | ||
The two things that should ring alarm bells are below. If you get them, move onto treatment: | |||
#[[Fever]], combined with | |||
#New onset [[murmur]]. | |||
Other things that can happen include | |||
*[[Tiredness]] - this occurs in about 90% of patients! | |||
*New [[rashes]], [[joint pain]], and other signs of systemic [[infection]]. | |||
===Investigations=== | ===Investigations=== | ||
===Management=== | ===Management=== | ||
Generally benzylpenicillin/vancomycin + gentamicin. This depends on the microbiology. | |||
===Prognosis=== | ===Prognosis=== | ||
Mortality rate of about 50%. NOT GOOD! | |||
Latest revision as of 15:00, 2 April 2010
Definition
Infection of the heart valves.
Epidemiology
About 1 in 25,000 incidence rate.
Pathophysiology
Since the valves do not have their own blood supply, the immune system can't get white cells to the valves, making them susceptable to bacterial infection.
There are two main types:
- Acute - usually caused by Staphylococcus epidermidis, comes on over a few days/weeks.
- Subacute - usually caused by Streptococcus viridans, and comes on over weeks.
Risk Factors
- Prosthetic heart valve.
- Recent dental work.
- Injecting drugs - can lead to staph infection from skin.
- Previous rheumatic fever - can cause damage to valves, making it easier for bacteria to stick on.
There are others, specially anything causing heart shape problems, weird murmurs or valve damage.
Clinical Features
The two things that should ring alarm bells are below. If you get them, move onto treatment:
Other things that can happen include
- Tiredness - this occurs in about 90% of patients!
- New rashes, joint pain, and other signs of systemic infection.
Investigations
Management
Generally benzylpenicillin/vancomycin + gentamicin. This depends on the microbiology.
Prognosis
Mortality rate of about 50%. NOT GOOD!