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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.
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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.
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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).
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Name the common organisms found in infective endocarditis.

Name the common organisms found in infective endocarditis.
 

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