Presentation is loading. Please wait.

Presentation is loading. Please wait.

Prepared by : Abdullah Mosluh Abdullah Academic No. :426810123 Bader Nasser Al-Msaed 1Infective ENDOCARDITIS.

Similar presentations

Presentation on theme: "Prepared by : Abdullah Mosluh Abdullah Academic No. :426810123 Bader Nasser Al-Msaed 1Infective ENDOCARDITIS."— Presentation transcript:

1 Prepared by : Abdullah Mosluh Abdullah Academic No. : Bader Nasser Al-Msaed 1Infective ENDOCARDITIS

2 Definition infection of the endocardial surface of the heart, which may include one or more heart valves, the mural endocardium, or a septal defect. Infectious endothelial lesions Called Vegetation Primarily complication of congenital heart disease 2Infective ENDOCARDITIS

3 pathogenesis 3Infective ENDOCARDITIS

4 pathogens cause infective endocarditis Who is at high risk of infection by this organism ? 4Infective ENDOCARDITIS

5 Clinical manifestation symptoms Constitutional Sweating Anroxia Weakness Chill Weight loss Myalgia Back pain 5Infective ENDOCARDITIS

6 DUKE CRITERIA MAJOR CRITERIA include : Microorganisms consistent with IE from persistently positive blood cultures defined as: Two positive cultures of blood samples drawn >12 hours apart, or All of 3 or a majority of 4 separate cultures of blood (with first and last sample drawn 1 hour apart) Coxiella burnetii detected by at least one positive blood culture or antiphase I IgG antibody titer >1:800 Evidence of endocardial involvement with positive echocardiogram defined as Vegetation on valve Abscess, or new valvular regurgitation (worsening or changing of preexisting murmur not sufficient) 6Infective ENDOCARDITIS

7 continue Minor criteria include: Predisposing factor: known cardiac lesion, recreational drug injection Fever >38°C Evidence of embolism: arterial emboli, pulmonary infarcts, Janeway lesions, conjunctival hemorrhage Immunological problems: glomerulonephritis, Osler's nodes roth spot rheumatoid factor Positive blood culture (that doesn't meet a major criterion) or serologic evidence of infection with organism consistent with IE but not satisfying major criterion 7Infective ENDOCARDITIS

8 The Roth Spot is a white-centered hemorrhage 8Infective ENDOCARDITIS

9 Osler Nodules Skin janeway lesion 9Infective ENDOCARDITIS

10 LABORATORY STUDIES & IMAGING Multiple blood cultures ESR& CRP Leukocytosis, anemia & hematuria +ve rheumatoid factor ECHO 10Infective ENDOCARDITIS

11 TREATMENT Acutely ill persons empirical antibiotic therapy Subacute disease wait results of blood cultures Bactericidal antibiotic 4 to 8 weeks IE ( viridans streptococci ) monotherapy penicillin G for 4 weeks 11Infective ENDOCARDITIS

12 Surgery will be indicated in the following conditions : Unsuccessful medical treatment with persistant bacterimia Fungal endocarditis Valve annulus or myocardial abscess Rupture of valve leaflet Valvular insufficiency with acute or refractory heart failure Recurrent serious embolic complications Refractory prosthetic valve disease 12Infective ENDOCARDITIS

13 Prosthetic cardiac valves Previous IE Unrepaired cyanotic congenital heart disease Valvular lesions in posttransplant pt. Oral amoxicillin 50 mg/ kg ( 30 – 60 min ) Clindamycin or azithromycin ( allergic to β – lactam) 13Infective ENDOCARDITIS

14 14Infective ENDOCARDITIS

Download ppt "Prepared by : Abdullah Mosluh Abdullah Academic No. :426810123 Bader Nasser Al-Msaed 1Infective ENDOCARDITIS."

Similar presentations

Ads by Google