initial therapy for IV related endocarditis
vancomycin
- empiric treatment for endocarditis in native valve should cover staph sensitive + resistant to methcillin, strep and enterococci
endocarditis - viridans susceptivle to penicillin - next step
treated with IV penicillin G or IV ceftriaxone for 4 wks
never oral in the beginning
active epididymitis - symptoms
- unilateral testicular pain
- epididymal edema
- dysuria + frequency (if coliform infection)
active epididymitis - epidemiology
- younger than 35: sexually trasmitted (chlamydia, gonorrhea) –> no urinary symptoms
- older than 35: bladder outlet obstruction (coliform bacteria: E.coli) –> urinary symptoms
active epididymitis - diagnosis
urinalysis/culture
NAAT for chlamydia + gonorrhea
active epididymitis - treatment
ceftriaxone/doxo (if STI)
levofloxacin (if colifom)
Eikinella corrodens endocarditis - think about
dental infection (gram (-) rob) (part of HACEK)
The MC valvular abnormality detected in patients with endocarditis
MVP with MR (5-8 times higher risk)
MCC of healthcare-associated infective endocarditis
staph
endocarditis - S. aureus - clinical associations
- prosthetic valces
- IV cthatheter
- Impanted devises
- IV drugs
endocarditis - S. viridans- clinical associations
- Resp track incision or biopsy
2. Gingival manipulation
endocarditis - S. epidermidis - clinical associations
- prosthetic valves
- implanted devises
- IV catheters
endocarditis - enterococci - clinical associations
Nosocomial UTI
endocarditis - S. gallolyticus (bovid) - clinical associations
- Colon ca
2. IBD
endocarditis - fungi - clinical associations
- immune
- IV catheters
- prolonged antibiotic therapy
suspicion of endocarditis - next step
3 cutlures from 3 different sites
