The Intern At Work: Internal Medicine 26. Heart of the Infection - Infective Endocarditis
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Apr 28, 2019 AI Snips
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How Endocarditis Develops
- Infective endocarditis is inflammation of the endocardium usually from bacteremia that seeds heart valves.
- Bacteria form adhesive biofilms on valves, creating vegetations that resist dislodgement and cause emboli or valve dysfunction.
Microbes That Should Trigger Echo
- Common organisms include Staphylococcus aureus, Streptococcus viridans, Streptococcus bovis, and Enterococcus.
- A blood culture positive for these organisms should prompt echocardiography to evaluate for endocarditis.
History And Exam Targets
- Ask about indwelling lines, recent dental work, skin infections, and injection drug use when assessing suspected endocarditis.
- Examine for track marks, abscesses, new murmurs, and signs of embolic or systemic complications.