Infective Endocarditis

Question 1

What are the symptoms of Infective Endocarditis?

Answer 1

• fever
• malaise
• fatigue
• bacteraemic episode
• weight loss
• musculoskeletal pain

Question 2

What are the signs of IE?

Answer 2

• new murmur/change to existing murmur
• congestive cardiac failure
• splinter haemorrhages
• Janeway lesions
• Roth spots
• nephritis
• focal neurological signs
• peripheral or pulmonary abscess/embolus
• vasculitic rash
• Osler’s nodes
• known IE organism isolated
• pyrexia of unknown origin

Question 3

What investigations would you do for IE?

Answer 3

• FBC
• CRP
• U+Es
• blood cultures
• urinalysis
• ECG
• CXR
• echo

Question 4

What are the major criteria for diagnosing IE?

Answer 4

• new murmur
• positive blood culture
• positive echo

Question 5

What are the minor criteria for diagnosis IE?

Answer 5

• fever
• positive blood culture not covered by major
• positive echo not covered by major
• valvular lesions
• predisposition to IE

Question 6

What is the treatment for IE?

Answer 6

• aminoglycosides
• IV gentamicin + IV amoxycillin
• IV vancomycin is penicillin allergic, severe sepsis or MRSA
• IV rifampicin + IV gentamicin + IV vancomycin if prosthetic valves