Endocarditis - Revision history

Rossdonaldson1: /* Evaluation */

2023-01-04T17:29:49Z

Evaluation

← Older revision		Revision as of 17:29, 4 January 2023
Line 69:		Line 69:
	[[File:PMC4497914 kjim-30-434-g003.png\|thumb\|Echocardiography showing typical vegetation on aortic valve (arrow).]]		[[File:PMC4497914 kjim-30-434-g003.png\|thumb\|Echocardiography showing typical vegetation on aortic valve (arrow).]]
	[[File:PMC2649868 ymj-50-152-g001.png\|thumb\|Transthoracic echocardiography shows vegetations (arrows) on both mitral leaflets; (A) Diastole. (B) Systole. LA, left atrium; LV, left ventricle; Ao, aorta.]]		[[File:PMC2649868 ymj-50-152-g001.png\|thumb\|Transthoracic echocardiography shows vegetations (arrows) on both mitral leaflets; (A) Diastole. (B) Systole. LA, left atrium; LV, left ventricle; Ao, aorta.]]
			[[File:PMC5412748 JCE-27-33-g010.png\|thumb\|Vegetations in infective endocarditis (arrows). (a) Transthoracic echocardiogram parasternal long-axis view showing vegetation on native aortic valve; (b) transesophageal echocardiography long axis of endocarditis of native aortic valve; (c) transesophageal echocardiography visualization of vegetation on the atrial side of mechanical mitral valve; (d) transesophageal echocardiography showing endocarditis of bioprosthetic mitral valve. LA: Left atrium; LV: Left ventricle.]]
	[[File:PMC5087261 JCHIMP-6-32827-g001.png\|thumb\|CT chest: Multiple cavitary (a) and pre-cavitary lesions (b) in both lung fields consistent septic emboli from pulmonary valve endocarditis.]]		[[File:PMC5087261 JCHIMP-6-32827-g001.png\|thumb\|CT chest: Multiple cavitary (a) and pre-cavitary lesions (b) in both lung fields consistent septic emboli from pulmonary valve endocarditis.]]
	===Work-Up===		===Work-Up===

Blsimpso: /* External Links */

2021-07-02T00:53:48Z

External Links

← Older revision		Revision as of 00:53, 2 July 2021
Line 204:		Line 204:
	==External Links==		==External Links==
	*[http://www.mdcalc.com/duke-criteria-for-infective-endocarditis/ MDCalc - Duke Criteria]		*[http://www.mdcalc.com/duke-criteria-for-infective-endocarditis/ MDCalc - Duke Criteria]
			*[https://emcrit.org/ibcc/endo/ EMCrit - Endocarditis]

	==References==		==References==

Blsimpso: /* Background */

2021-06-24T19:56:41Z

Background

← Older revision		Revision as of 19:56, 24 June 2021
Line 1:		Line 1:
	==Background==		==Background==
			*Defined as an infection of the endocardial surface of the heart, affecting native (or prosthetic) heart valves as well as in-dwelling cardiac devices
	*Consider in patients with known risk factors and unexplained fever		*Consider in patients with known risk factors and unexplained fever
	*Mitral valve most commonly affected overall; tricuspid valve most common in IVDA		*Mitral valve most commonly affected overall; tricuspid valve most common in IVDA
	*Noninfectious vegetations can arise in patients with malignancy/[[SLE]]/Hypercoagulable state ("Marantic" endocarditis)		*Noninfectious vegetations can arise in patients with malignancy/[[SLE]]/Hypercoagulable state ("Marantic" endocarditis)
	*[[S. aureus]] is single most common cause		*[[S. aureus]] is single most common cause (accounts for 1/3 of all cases)<ref>Selton-Suty C, Célard M, Le Moing V, et al. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis. 2012;54(9):1230-1239. doi:10.1093/cid/cis199</ref>
	*[[Strep viridans]] is the most common cause of native valve endocarditis, excluding risk factors below		*[[Strep viridans]] is the most common cause of native valve endocarditis, excluding risk factors below
	*[[Blood cultures]] are falsely negative ~5% (think HACEK organisms)		*[[Blood cultures]] are falsely negative ~5% (think HACEK organisms)
Line 17:		Line 18:
	**Coagulase negative [[staph]]ylcocci are substantial etiologies in this patient population<ref>Lalani T et al. Prosthetic valve endocarditis due to coagulase-negative staphylococci: findings from the International Collaboration on Endocarditis Merged Database. Eur J Clin Microbiol Infect Dis. 2006 Jun;25(6):365-8.</ref>		**Coagulase negative [[staph]]ylcocci are substantial etiologies in this patient population<ref>Lalani T et al. Prosthetic valve endocarditis due to coagulase-negative staphylococci: findings from the International Collaboration on Endocarditis Merged Database. Eur J Clin Microbiol Infect Dis. 2006 Jun;25(6):365-8.</ref>
	*Structural heart disease		*Structural heart disease
	**Rheumatic heart disease		**Rheumatic heart disease (biggest risk factor in low-income countries)
	**Mitral valve prolapse		**Mitral valve prolapse
	**Bicuspid aortic valve		**Bicuspid aortic valve

Rossdonaldson1: /* Evaluation */

2021-03-18T15:11:11Z

Evaluation

← Older revision		Revision as of 15:11, 18 March 2021
Line 68:		Line 68:
	[[File:PMC4497914 kjim-30-434-g003.png\|thumb\|Echocardiography showing typical vegetation on aortic valve (arrow).]]		[[File:PMC4497914 kjim-30-434-g003.png\|thumb\|Echocardiography showing typical vegetation on aortic valve (arrow).]]
	[[File:PMC2649868 ymj-50-152-g001.png\|thumb\|Transthoracic echocardiography shows vegetations (arrows) on both mitral leaflets; (A) Diastole. (B) Systole. LA, left atrium; LV, left ventricle; Ao, aorta.]]		[[File:PMC2649868 ymj-50-152-g001.png\|thumb\|Transthoracic echocardiography shows vegetations (arrows) on both mitral leaflets; (A) Diastole. (B) Systole. LA, left atrium; LV, left ventricle; Ao, aorta.]]
			[[File:PMC5087261 JCHIMP-6-32827-g001.png\|thumb\|CT chest: Multiple cavitary (a) and pre-cavitary lesions (b) in both lung fields consistent septic emboli from pulmonary valve endocarditis.]]
	===Work-Up===		===Work-Up===
	*[[Blood culture]] (from 3 separate sites)<ref name="cultures">Lee A, Mirrett S, Reller LB, Weinstein MP. Detection of bloodstream infections in adults: how many blood cultures are needed? J Clin Microbiol 2007;45:		*[[Blood culture]] (from 3 separate sites)<ref name="cultures">Lee A, Mirrett S, Reller LB, Weinstein MP. Detection of bloodstream infections in adults: how many blood cultures are needed? J Clin Microbiol 2007;45:

Rossdonaldson1: /* Evaluation */

2021-03-18T14:45:56Z

Evaluation

← Older revision		Revision as of 14:45, 18 March 2021
Line 67:		Line 67:
	==Evaluation==		==Evaluation==
	[[File:PMC4497914 kjim-30-434-g003.png\|thumb\|Echocardiography showing typical vegetation on aortic valve (arrow).]]		[[File:PMC4497914 kjim-30-434-g003.png\|thumb\|Echocardiography showing typical vegetation on aortic valve (arrow).]]
			[[File:PMC2649868 ymj-50-152-g001.png\|thumb\|Transthoracic echocardiography shows vegetations (arrows) on both mitral leaflets; (A) Diastole. (B) Systole. LA, left atrium; LV, left ventricle; Ao, aorta.]]
	===Work-Up===		===Work-Up===
	*[[Blood culture]] (from 3 separate sites)<ref name="cultures">Lee A, Mirrett S, Reller LB, Weinstein MP. Detection of bloodstream infections in adults: how many blood cultures are needed? J Clin Microbiol 2007;45:		*[[Blood culture]] (from 3 separate sites)<ref name="cultures">Lee A, Mirrett S, Reller LB, Weinstein MP. Detection of bloodstream infections in adults: how many blood cultures are needed? J Clin Microbiol 2007;45:

Rossdonaldson1: /* Clinical Features */

2021-03-18T14:42:45Z

Clinical Features

← Older revision		Revision as of 14:42, 18 March 2021
Line 28:		Line 28:
	==Clinical Features==		==Clinical Features==
	[[File:Splinter hemorrhage.jpg\|thumb\|Splinter hemorrhage]]		[[File:Splinter hemorrhage.jpg\|thumb\|Splinter hemorrhage]]
	[[File:Osler Nodules Hand.jpg\|thumb\|Osler's ~~node~~.]]		[[File:Osler Nodules Hand.jpg\|thumb\|Osler's nodes.]]
	[[File:PMC5072319 12879 2016 1912 Fig2 HTML.png\|thumb\|Janeway ~~lesion's~~]]		[[File:PMC5072319 12879 2016 1912 Fig2 HTML.png\|thumb\|Janeway lesions]]
	[[File:PMC5059132 kjtcv-49-408f1.png\|thumb\|Roth spots on fundoscopy (A); 2 weeks after treatment (B); 6 weeks after treatment.]]		[[File:PMC5059132 kjtcv-49-408f1.png\|thumb\|Roth spots on fundoscopy (A); 2 weeks after treatment (B); 6 weeks after treatment.]]
	*[[Fever]]		*[[Fever]]

Rossdonaldson1: /* Clinical Features */

2021-03-18T14:41:30Z

Clinical Features

← Older revision		Revision as of 14:41, 18 March 2021
Line 30:		Line 30:
	[[File:Osler Nodules Hand.jpg\|thumb\|Osler's node.]]		[[File:Osler Nodules Hand.jpg\|thumb\|Osler's node.]]
	[[File:PMC5072319 12879 2016 1912 Fig2 HTML.png\|thumb\|Janeway lesion's]]		[[File:PMC5072319 12879 2016 1912 Fig2 HTML.png\|thumb\|Janeway lesion's]]
			[[File:PMC5059132 kjtcv-49-408f1.png\|thumb\|Roth spots on fundoscopy (A); 2 weeks after treatment (B); 6 weeks after treatment.]]
	*[[Fever]]		*[[Fever]]
	**Present in 80% of cases		**Present in 80% of cases

Rossdonaldson1: /* Clinical Features */

2021-03-18T14:39:12Z

Clinical Features

← Older revision		Revision as of 14:39, 18 March 2021
Line 55:		Line 55:
	*Abdominal		*Abdominal
	**Bowel, renal, splenic infarcts		**Bowel, renal, splenic infarcts
			*Ophtho
			**Roth spots
			***White centered retinal hemorrhage
			***Associated with multiple systemic illnesses, most commonly bacterial endocarditis

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Clinical Features */

2021-03-18T14:37:40Z

Clinical Features

← Older revision		Revision as of 14:37, 18 March 2021
Line 29:		Line 29:
	[[File:Splinter hemorrhage.jpg\|thumb\|Splinter hemorrhage]]		[[File:Splinter hemorrhage.jpg\|thumb\|Splinter hemorrhage]]
	[[File:Osler Nodules Hand.jpg\|thumb\|Osler's node.]]		[[File:Osler Nodules Hand.jpg\|thumb\|Osler's node.]]
			[[File:PMC5072319 12879 2016 1912 Fig2 HTML.png\|thumb\|Janeway lesion's]]
	*[[Fever]]		*[[Fever]]
	**Present in 80% of cases		**Present in 80% of cases

Rossdonaldson1: /* Clinical Features */

2021-03-18T14:34:35Z

Clinical Features

← Older revision		Revision as of 14:34, 18 March 2021
Line 28:		Line 28:
	==Clinical Features==		==Clinical Features==
	[[File:Splinter hemorrhage.jpg\|thumb\|Splinter hemorrhage]]		[[File:Splinter hemorrhage.jpg\|thumb\|Splinter hemorrhage]]
			[[File:Osler Nodules Hand.jpg\|thumb\|Osler's node.]]
	*[[Fever]]		*[[Fever]]
	**Present in 80% of cases		**Present in 80% of cases

← Older revision		Revision as of 17:29, 4 January 2023
Line 69:		Line 69:
	[[File:PMC4497914 kjim-30-434-g003.png\|thumb\|Echocardiography showing typical vegetation on aortic valve (arrow).]]		[[File:PMC4497914 kjim-30-434-g003.png\|thumb\|Echocardiography showing typical vegetation on aortic valve (arrow).]]
	[[File:PMC2649868 ymj-50-152-g001.png\|thumb\|Transthoracic echocardiography shows vegetations (arrows) on both mitral leaflets; (A) Diastole. (B) Systole. LA, left atrium; LV, left ventricle; Ao, aorta.]]		[[File:PMC2649868 ymj-50-152-g001.png\|thumb\|Transthoracic echocardiography shows vegetations (arrows) on both mitral leaflets; (A) Diastole. (B) Systole. LA, left atrium; LV, left ventricle; Ao, aorta.]]
			[[File:PMC5412748 JCE-27-33-g010.png\|thumb\|Vegetations in infective endocarditis (arrows). (a) Transthoracic echocardiogram parasternal long-axis view showing vegetation on native aortic valve; (b) transesophageal echocardiography long axis of endocarditis of native aortic valve; (c) transesophageal echocardiography visualization of vegetation on the atrial side of mechanical mitral valve; (d) transesophageal echocardiography showing endocarditis of bioprosthetic mitral valve. LA: Left atrium; LV: Left ventricle.]]
	[[File:PMC5087261 JCHIMP-6-32827-g001.png\|thumb\|CT chest: Multiple cavitary (a) and pre-cavitary lesions (b) in both lung fields consistent septic emboli from pulmonary valve endocarditis.]]		[[File:PMC5087261 JCHIMP-6-32827-g001.png\|thumb\|CT chest: Multiple cavitary (a) and pre-cavitary lesions (b) in both lung fields consistent septic emboli from pulmonary valve endocarditis.]]
	===Work-Up===		===Work-Up===