8.5 - Endocarditis

Question 1

which organism is the most common overall cause of endocarditis? what structure does it prefer to infect?

Answer 1

• viridans strep

- previously damaged valves

Question 2

what is the most common organism responsible for IV DRUG endocarditis?

Answer 2

staph aureus

Question 3

does staph aureus induced endocarditis lead to valvular damage?

Answer 3

yes (acute endocarditis)

Question 4

what organism is responsible for endocarditis of prosthetic valves?

Answer 4

staph epidermidis

Question 5

what organism is responsible for endocarditis in patients with underlying colorectal carcinoma?

Answer 5

strep bovis

Question 6

a diagnosis of endocarditis is made, but cultures return negative. what organisms could be responsible?

Answer 6

HACEK:

• haemophilus
• actinobacillus
• cadiobacterium
• eikenella
• kingella

Question 7

what are the clinical features of bacterial endocarditis?

Answer 7

• fever
• murmur
• janeway lesions
• osler nodes
• spinter hemorrhages
• roth spots

Question 8

what are janeway lesions? when / where are they seen?

Answer 8

• erythematous nontender lesions on palms and soles

- bacterial endocarditis

Question 9

what are osler nodes? when / where are they seen?

Answer 9

• tender lesions on fingers or toes

- bacterial endocarditis

Question 10

what are splinter hemorrhages? when / where are they seen?

Answer 10

• hemorrhages in nail bed

- bacterial endocarditis

Question 11

what are roth sports? when / where are they seen?

Answer 11

• embolization of septic vegetations

- bacterial endocarditis

Question 12

what type of anemia is seen with bacterial endocarditis?

Answer 12

microcytic

Question 13

what are the lab values in bacterial endocarditis for:

• Hb
• MCV
• ferritin
• TIBC
• serum iron
• % sat iron

Answer 13

• Hb: decreased
• MCV: decreased
• ferritin: elevated
• TIBC: decreased
• serum iron: decreased
• % sat iron: decreased

Question 14

what is libman sacks endocarditis? what is a possible sequela?

Answer 14

• sterile vegetations that arise in association with SLE

- vegetations are present on the surface and undersurface of the mitral valve and result in mitral regurgitation