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Showing posts with label Infective endocarditis. Show all posts
Showing posts with label Infective endocarditis. Show all posts

What are the complications of infective endocarditis ?

What are the complications of infective endocarditis ?

 • Congestive heart failure: may develop acutely or insidiously; it portends a grave prognosis. • Conduction disturbances caused by abscesses in ventricular septum.

 • Valve destruction: acute regurgitation, pulmonary oedema, heart failure.

• Embolism: occurs in 22-50% of cases, leading to infarction in any vascular bed including lungs, coronary arteries, spleen, bowel, and extremities; renal: flank pain and haematuria.

• Local extension of infection: purulent pericarditis, aortic root abscess (may cause sinus Valsalva fistula), myocardial abscess (conduction disturbance).

• Septic emboli to vasa vasorum: may lead to mycotic aneurysms anywhere in vas-cular tree; most worrying in cerebral vessels, resulting in cerebral haemorrhage. • Distal infection (metastatic): due to septic emboli, e.g. brain abscess, cerebritis. • Candidal endocarditis: may be manifest by fungal endophthalmitis.

• Glomerulonephritis: the renal lesions of SBE are of two kinds, (a) a diffuse pro-liferative glomerulonephritis and (b) focal embolic glomerulonephritis. This is associated with low complement levels and immune complexes.
What are the complications of infective endocarditis ?

 • Congestive heart failure: may develop acutely or insidiously; it portends a grave prognosis. • Conduction disturbances caused by abscesses in ventricular septum.

 • Valve destruction: acute regurgitation, pulmonary oedema, heart failure.

• Embolism: occurs in 22-50% of cases, leading to infarction in any vascular bed including lungs, coronary arteries, spleen, bowel, and extremities; renal: flank pain and haematuria.

• Local extension of infection: purulent pericarditis, aortic root abscess (may cause sinus Valsalva fistula), myocardial abscess (conduction disturbance).

• Septic emboli to vasa vasorum: may lead to mycotic aneurysms anywhere in vas-cular tree; most worrying in cerebral vessels, resulting in cerebral haemorrhage. • Distal infection (metastatic): due to septic emboli, e.g. brain abscess, cerebritis. • Candidal endocarditis: may be manifest by fungal endophthalmitis.

• Glomerulonephritis: the renal lesions of SBE are of two kinds, (a) a diffuse pro-liferative glomerulonephritis and (b) focal embolic glomerulonephritis. This is associated with low complement levels and immune complexes.

Mention a few conditions that can simulate clinical manifestations of infective endocarditis.

Mention a few conditions that can simulate clinical manifestations of infective endocarditis. 

• Atrial myxoma.
• Non-bacterial endocarditis.
• Systemic lupus erythematosus (SLE).
• Sickle cell disease.
Mention a few conditions that can simulate clinical manifestations of infective endocarditis. 

• Atrial myxoma.
• Non-bacterial endocarditis.
• Systemic lupus erythematosus (SLE).
• Sickle cell disease.

How would you treat a patient suspected to have endocarditis ?

How would you treat a patient suspected to have endocarditis ? 

Until the bacteriology results are available, with intravenous benzylpenicillin and gentamicin. 

In severely ill patients intravenous cloxacillin would be added to this regimen (Circulation 1998; 98: 293648).
How would you treat a patient suspected to have endocarditis ? 

Until the bacteriology results are available, with intravenous benzylpenicillin and gentamicin. 

In severely ill patients intravenous cloxacillin would be added to this regimen (Circulation 1998; 98: 293648).

Name the common organisms found in infective endocarditis.

Name the common organisms found in infective endocarditis.
 

Streptococcus viridans, Staphylococcus aureus, Strep.faecahs, fungi.
Name the common organisms found in infective endocarditis.
 

Streptococcus viridans, Staphylococcus aureus, Strep.faecahs, fungi.

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