Clinical Presentation
What is the most common symptom of infective endocarditis?
Fever
How many major criteria are needed for a definite diagnosis of IE?
Two major criteria
What is the most common organism in native valve endocarditis?
Staph aureus
What is the typical duration of antibiotic therapy for IE?
4-6 weeks
What is the most common cardiac complication of IE?
Heart failure
Name two peripheral stigmata of infective endocarditis.
Janeway lesions and Osler nodes
Name one major Duke criterion.
Positive blood cultures for typical organisms
Which group of organisms is associated with culture-negative IE?
HACEK organisms
What is the empiric treatment for native valve IE in IVDU?
Vancomycin + Ceftriaxone
What size of vegetation increases the risk of embolization?
>10 mm
What type of murmur is most commonly heard in right-sided endocarditis?
Tricuspid regurgitation murmur
What imaging modality is used most often to detect vegetations?
Echocardiography (TTE or TEE)
What organism is commonly associated with dental procedures?
Viridans group streptococci
What antibiotic is used for MSSA endocarditis?
Nafcillin or Oxacillin or Cefazolin
Name one indication for surgical intervention in IE.
Valve dysfunction causing heart failure
Cardiogenic shock
Perivalvular abscess
What is the significance of splinter hemorrhages?
They are a vascular phenomenon associated with IE.
What minor criterion includes IV drug use?
Predisposing heart condition or IV drug use
What is the most common cause of prosthetic valve endocarditis?
Coagulase-negative staphylococci
What is the role of gentamicin in IE treatment?
Synergistic therapy in some cases (e.g., enterococcal IE)
What is a mycotic aneurysm?
An infected arterial aneurysm caused by septic emboli
What is the most common risk factor for right-sided endocarditis?
Intravenous drug use
What combination of Duke criteria confirms a definite diagnosis?
2 major, or 1 major + 3 minor, or 5 minor
What organism is associated with colon cancer and endocarditis?
Streptococcus gallolyticus (formerly S. bovis)
What is the preferred route of antibiotic administration?
Intravenous (IV)
What is the mortality rate of untreated IE?
Up to 100%