This document provides an overview of infective endocarditis. It discusses the epidemiology, etiologies, pathogenesis, clinical manifestations, diagnosis, complications and treatment of the condition. Some key points include:
- Infective endocarditis is an infection of the heart valves or endocardium that often involves vegetation formation. It is usually caused by bacteria and has significant morbidity and mortality.
- Native or prosthetic heart valves are most commonly infected. Streptococci and Staphylococcus aureus are leading causes.
- Symptoms can include fever, heart murmur, embolic phenomena. Diagnosis involves blood cultures, echocardiogram and applying the Duke criteria.
- Complications
Infective endocarditis is inflammation of the heart valves caused by bacterial infection. It is often a complication of congenital or rheumatic heart disease. Common causative organisms include streptococci and staphylococci. Risk factors include prior heart disease, dental/medical procedures, and intravenous drug use. Symptoms include fever, chills, weight loss and heart murmurs. Echocardiography and blood cultures help diagnose. Treatment involves antibiotics for 4-6 weeks. Surgery may be needed for severe valve damage or persistent infection. Prognosis remains serious despite treatment, with 20-25% mortality and high morbidity rates.
Infective endocarditis is an infection of the heart valves or endocardial surface. It can be classified based on temporal evolution (acute vs subacute), site of infection, cause, or risk factors. Acute infective endocarditis typically affects normal valves and is caused by virulent organisms like S. aureus, while subacute infective endocarditis often affects damaged valves and has a more indolent course. Diagnosis involves blood cultures, echocardiography, and application of the Duke criteria. Effective treatment requires antibiotics, while complications include embolization, heart failure, and immune-mediated issues.
Basic description of Infective Endocarditis from a Clinical and Microbiological point of view with description on Pathogenesis, Clinical Manifestations, Clinical and Laboratory diagnosis.
This document discusses infective endocarditis, including its epidemiology, classification, predisposing factors, microbiology, pathogenesis, diagnosis, management, treatment, and prophylaxis. It notes that infective endocarditis is an infection of the endocardial lining of the heart, usually caused by bacteria. It can be either acute or subacute and most commonly affects patients with pre-existing heart disease. Common causative organisms include streptococci and staphylococci. Diagnosis is based on the modified Duke criteria and involves blood cultures, echocardiography, and clinical signs. Treatment involves prolonged antibiotic therapy based on culture results, often for 6 weeks. Prophylaxis with antibiotics is recommended for certain medical
Infective endocarditis is a microbial infection of the heart valves or endocardium. It typically involves the valves and can be caused by many pathogens. The most common causes are streptococci, staphylococci, and enterococci. Untreated infective endocarditis has a high fatality rate. The pathogenesis involves endothelial damage, platelet-fibrin deposition forming nonbacterial thrombotic endocarditis (NBTE), and microbial colonization of the NBTE resulting in bacterial vegetations. Local effects include valvular damage, abscesses, fistulae, and conduction abnormalities. Distant effects occur via septic emboli that can lodge in organs like the brain, lungs,
This document discusses shock in children, defining it as impaired tissue perfusion resulting from an imbalance between oxygen demand and supply. Shock can be classified as hypovolemic, cardiogenic, or distributive based on the underlying cause. Signs of shock in children may be more subtle than in adults since children can maintain blood pressure through compensatory mechanisms even as tissue perfusion decreases. Early signs include tachycardia and signs of poor peripheral perfusion rather than hypotension. Management involves rapid fluid resuscitation and vasoactive drugs to support circulation as needed based on the type of shock present. The goal is to restore adequate organ perfusion and oxygen delivery.
This document discusses infective endocarditis (IE), including:
- IE is caused by microbial infection of the heart endothelium or foreign bodies like prosthetic valves. It is life-threatening but uncommon. Morbidity and mortality remain high despite advances.
- Incidence is estimated at 1.7-6.2 per 100,000 patient-years in Western countries and 17,000 cases per year in India, often affecting younger patients with rheumatic or congenital heart disease.
- Staphylococcus aureus is the most common cause in developed nations while viridans group streptococci are common in developing countries. Multidrug resistance is a growing problem.
- Diagnosis
This document provides information about infective endocarditis:
- Infective endocarditis is a microbial infection of the heart valves, heart lining, or blood vessels that is usually caused by bacteria.
- It can affect both native and prosthetic heart valves. Staphylococcus aureus is now the most common cause.
- Diagnosis is based on modified Duke criteria using clinical findings, blood cultures, and echocardiography findings. Treatment involves prolonged antibiotic therapy and may require surgery to remove infected tissues.
- Complications can include heart valve damage, embolic events, heart failure, and extension of the infection. Proper antibiotic prophylaxis is important for those at high risk
Infective endocarditis is inflammation of the heart valves caused by bacterial infection. It is often a complication of congenital or rheumatic heart disease. Common causative organisms include streptococci and staphylococci. Risk factors include prior heart disease, dental/medical procedures, and intravenous drug use. Symptoms include fever, chills, weight loss and heart murmurs. Echocardiography and blood cultures help diagnose. Treatment involves antibiotics for 4-6 weeks. Surgery may be needed for severe valve damage or persistent infection. Prognosis remains serious despite treatment, with 20-25% mortality and high morbidity rates.
Infective endocarditis is an infection of the heart valves or endocardial surface. It can be classified based on temporal evolution (acute vs subacute), site of infection, cause, or risk factors. Acute infective endocarditis typically affects normal valves and is caused by virulent organisms like S. aureus, while subacute infective endocarditis often affects damaged valves and has a more indolent course. Diagnosis involves blood cultures, echocardiography, and application of the Duke criteria. Effective treatment requires antibiotics, while complications include embolization, heart failure, and immune-mediated issues.
Basic description of Infective Endocarditis from a Clinical and Microbiological point of view with description on Pathogenesis, Clinical Manifestations, Clinical and Laboratory diagnosis.
This document discusses infective endocarditis, including its epidemiology, classification, predisposing factors, microbiology, pathogenesis, diagnosis, management, treatment, and prophylaxis. It notes that infective endocarditis is an infection of the endocardial lining of the heart, usually caused by bacteria. It can be either acute or subacute and most commonly affects patients with pre-existing heart disease. Common causative organisms include streptococci and staphylococci. Diagnosis is based on the modified Duke criteria and involves blood cultures, echocardiography, and clinical signs. Treatment involves prolonged antibiotic therapy based on culture results, often for 6 weeks. Prophylaxis with antibiotics is recommended for certain medical
Infective endocarditis is a microbial infection of the heart valves or endocardium. It typically involves the valves and can be caused by many pathogens. The most common causes are streptococci, staphylococci, and enterococci. Untreated infective endocarditis has a high fatality rate. The pathogenesis involves endothelial damage, platelet-fibrin deposition forming nonbacterial thrombotic endocarditis (NBTE), and microbial colonization of the NBTE resulting in bacterial vegetations. Local effects include valvular damage, abscesses, fistulae, and conduction abnormalities. Distant effects occur via septic emboli that can lodge in organs like the brain, lungs,
This document discusses shock in children, defining it as impaired tissue perfusion resulting from an imbalance between oxygen demand and supply. Shock can be classified as hypovolemic, cardiogenic, or distributive based on the underlying cause. Signs of shock in children may be more subtle than in adults since children can maintain blood pressure through compensatory mechanisms even as tissue perfusion decreases. Early signs include tachycardia and signs of poor peripheral perfusion rather than hypotension. Management involves rapid fluid resuscitation and vasoactive drugs to support circulation as needed based on the type of shock present. The goal is to restore adequate organ perfusion and oxygen delivery.
This document discusses infective endocarditis (IE), including:
- IE is caused by microbial infection of the heart endothelium or foreign bodies like prosthetic valves. It is life-threatening but uncommon. Morbidity and mortality remain high despite advances.
- Incidence is estimated at 1.7-6.2 per 100,000 patient-years in Western countries and 17,000 cases per year in India, often affecting younger patients with rheumatic or congenital heart disease.
- Staphylococcus aureus is the most common cause in developed nations while viridans group streptococci are common in developing countries. Multidrug resistance is a growing problem.
- Diagnosis
This document provides information about infective endocarditis:
- Infective endocarditis is a microbial infection of the heart valves, heart lining, or blood vessels that is usually caused by bacteria.
- It can affect both native and prosthetic heart valves. Staphylococcus aureus is now the most common cause.
- Diagnosis is based on modified Duke criteria using clinical findings, blood cultures, and echocardiography findings. Treatment involves prolonged antibiotic therapy and may require surgery to remove infected tissues.
- Complications can include heart valve damage, embolic events, heart failure, and extension of the infection. Proper antibiotic prophylaxis is important for those at high risk
Endocarditis is an inflammatory process of the inner lining of the heart. Bacteria enter the bloodstream and colonize on heart valves, forming clots and vegetations that can damage valves and embolize to other organs. Symptoms are non-specific but may include fever, heart murmur, petechiae, splinter hemorrhages, and signs of infection in other organs. Treatment involves intravenous antibiotics for 4 weeks or more. Nursing care focuses on monitoring for signs of infection, complications affecting organs, and managing symptoms like fever while the patient completes the long antibiotic regimen.
This document outlines a presidential action plan for infectious endocarditis in children. It begins with definitions of infective endocarditis and discusses the epidemiology, pathogenesis, clinical features, diagnosis, treatment and prevention. Key points include that infective endocarditis is less common in children than adults but is increasing in those with cardiac surgery or conditions. Common causes are streptococcal and staphylococcal species. Clinical features may include fever, heart murmur and embolic phenomena. Echocardiography is important for diagnosis but blood cultures are also needed under the modified Duke criteria. Surgery may be indicated for complications such as heart failure or abscesses.
This document provides an overview of infective endocarditis (IE), including its introduction, classification, pathogenesis, clinical manifestations, diagnosis, and treatment. Some key points:
- IE is defined as an infection of the inner lining of the heart (endocardium) that can involve heart valves, the inner lining of the heart chambers, or defects in the heart wall.
- It is classified based on temporal evolution (acute vs. subacute) and location (native valve, prosthetic valve, device-related, right-sided). Common causes include streptococci, staphylococci, and enterococci.
- Diagnosis is based on the Modified Duke Criteria, which considers
Endocarditis is an infection of the inner lining of the heart (endocardium). It is usually caused by bacteria or fungi entering the bloodstream from another part of the body. Common symptoms include fever and heart murmur. Diagnosis involves blood tests, echocardiogram, and blood cultures. Treatment requires long-term antibiotics and may require surgery to replace damaged heart valves. Complications can include heart failure, stroke, kidney damage, and embolisms in other parts of the body.
This document discusses congestive heart failure in children. It defines CHF as the heart's inability to meet metabolic demands due to reduced cardiac output or inability to dispose of venous return. Key factors affecting cardiac performance are preload, afterload, and contractility. Compensatory mechanisms in heart failure involve cardiac, systemic, and neurohormonal responses. Etiologies of pediatric CHF include congenital heart defects, cardiomyopathies, and acquired conditions. The document outlines approaches to diagnosis, treatment including medications to reduce preload and afterload, and non-pharmacological options.
This document discusses acute kidney injury (AKI), including its definition, diagnosis criteria, epidemiology, classification, pathogenesis, etiology, treatment, and management. AKI is defined as an abrupt reduction in kidney function, diagnosed by changes in serum creatinine, BUN, and urine output. Between 5-7% of hospitalized patients and a greater percentage of ICU patients develop AKI. Mortality from AKI exceeds 50% despite improvements in care. AKI is classified using criteria like RIFLE, AKIN, and KDIGO which consider risk, injury, failure, and loss of kidney function. Causes include prerenal issues like dehydration, intrinsic renal damage, and postrenal obstruction
Myocarditis is an inflammatory disease of the heart muscle that can be caused by infectious or non-infectious triggers. It has a variable clinical presentation ranging from mild symptoms to life-threatening cardiogenic shock. Diagnosis is challenging but can involve elevated cardiac biomarkers, ECG abnormalities, echocardiogram findings of ventricular dysfunction, and cardiovascular MRI or endomyocardial biopsy showing inflammatory infiltrates. Treatment focuses on managing heart failure symptoms and arrhythmias with medications like diuretics, ACE inhibitors, beta-blockers, and avoiding digoxin in acute heart failure. The prognosis varies from complete recovery to chronic dilated cardiomyopathy or sudden death.
This document provides an overview of infective endocarditis, including its definition, pathogenesis, epidemiology, clinical presentation, diagnosis, and treatment. It defines infective endocarditis as a microbial infection of the heart valves or endocardium. It discusses the typical pathogens involved and describes the formation of vegetations on heart valves. It also outlines the diagnostic criteria, including blood cultures and echocardiography. Treatment involves prolonged antibiotic therapy tailored to the causative organism, and may require surgery in cases of heart failure or uncontrolled infection.
Definition, classification, epidemiology, etiology, diagnosis, prognosis of DCM, HOCM, LVNC
Also review of acute myocarditis in children
R/v of heart failure management
This document discusses heart failure in children, including its definition, types, causes, symptoms, diagnosis, complications, and management. Heart failure occurs when the heart cannot pump enough blood to meet the body's needs. In children, common causes include congenital heart disease, rheumatic heart disease, and cardiomyopathy. Symptoms vary by age but may include feeding issues, sweating, poor growth, and edema. Diagnosis involves exams, chest x-rays, electrocardiograms, and echocardiograms. Complications can include arrhythmias, infections, and damage to other organs. Treatment focuses on supportive care, medications to improve heart function, and treating the underlying cause. Prognosis depends on the cause,
This document discusses heart failure in children. It defines heart failure as the heart's inability to pump enough blood to meet the body's needs. The key factors that affect cardiac performance are preload, afterload, and contractility. In children, common causes of heart failure include congenital heart defects, cardiomyopathy, and acquired conditions like myocarditis. Symptoms depend on whether left-sided or right-sided heart failure predominates. Treatment focuses on correcting underlying causes, diet modification, diuretics to reduce preload, digitalis to improve contractility, and dilators to reduce afterload. Imaging studies like echocardiograms are important for diagnosis.
Acute kidney injury (AKI), formerly known as acute renal failure, is defined as a sudden deterioration of kidney function resulting in the inability to maintain fluid and electrolyte homeostasis. It can be caused by prerenal issues affecting blood flow to the kidneys, intrinsic renal parenchymal damage, or postrenal urinary tract obstruction. The incidence of AKI varies globally and it commonly occurs in critically ill children with coexisting conditions. Etiologies include pre-renal causes like decreased intravascular volume, intrinsic renal diseases affecting glomeruli or tubules, and post-renal obstruction. Diagnosis involves lab tests of kidney and liver function as well as imaging studies. Treatment focuses on fluid management, electrolyte
Acute poststreptococcal glomerulonephritis (APSGN) is characterized by sudden edema, hematuria, proteinuria, and hypertension 1-4 weeks after a streptococcal infection. Histologically, there is diffuse proliferation of glomerular cells and leukocytes. It is caused by immune complexes forming in response to certain M protein serotypes of streptococcus. On microscopy, there are subepithelial immune deposits, complement activation, and inflammation, appearing as "humps". Patients typically experience malaise, fever, nausea, and hematuria after a sore throat. Laboratory findings include elevated antibody titers and low complement levels. Most children fully recover with conservative care, while a small percentage progress
Infective endocarditis is an infection of the inner lining of the heart chambers and heart valves. It has an incidence of about 1 in 1,000 hospital admissions and risks include structural heart disease, immunosuppression, pacemakers, prolonged cardiac surgery, intravenous drug use, and nosocomial infections. Clinical presentations can be acute with toxicity and metastatic infection developing over days to weeks, or subacute progressing over weeks to months with less toxicity. Complications include heart failure, abscesses, and embolism, with an overall mortality rate of 10-20%. Treatment involves antibiotics tailored to the infecting organism and surgery may be required in some cases.
This document provides information about endocarditis, including:
- Endocarditis is an inflammation of the inner lining of the heart and heart valves. It is commonly caused by a heart valve infection from microorganisms entering the bloodstream.
- It is classified as either acute or subacute based on symptoms and causative organisms. Common causative organisms include streptococci, staphylococci, and enterococci.
- Risk factors include age over 50, pre-existing heart conditions, IV drug use, and dental procedures. Diagnosis involves blood cultures, echocardiogram, and application of the Modified Duke Criteria. Treatment involves antibiotics targeting the causative organism along with possible surgery
The document discusses cardiogenic shock, which results from inadequate tissue perfusion due to cardiac dysfunction. Cardiogenic shock is defined by a sustained systolic blood pressure below 90 mm Hg, cardiac index below 2.2 L/min/m2, and pulmonary capillary wedge pressure above 15 mm Hg. Causes of cardiogenic shock include acute myocardial infarction, mechanical complications, right ventricular infarction, and other conditions such as cardiomyopathy. The pathophysiology and management of cardiogenic shock are discussed.
This document discusses myocarditis in children. It defines myocarditis and describes the epidemiology, etiology, pathophysiology, clinical presentation, diagnosis and treatment. Myocarditis has many potential causes including viruses like adenovirus and enterovirus. Clinically it presents variably depending on age from nonspecific symptoms to heart failure. Diagnosis involves blood tests, ECG, imaging like echocardiogram and cardiac MRI, and endomyocardial biopsy. Treatment is supportive with heart failure medications, antivirals may help, and immunosuppressants can reduce inflammation and improve function.
This document provides information about infective endocarditis, including its causes, risk factors, clinical manifestations, diagnosis, treatment, nursing care, and prevention. Infective endocarditis is an infection of the heart valves and lining that can be caused by bacteria or fungi entering the bloodstream. It requires long-term antibiotic treatment and may necessitate valve replacement surgery if complications occur. Nurses monitor for symptoms, assess treatment effectiveness, and educate patients on preventing future infections.
This document outlines a lecture on pediatric infective endocarditis. It discusses the epidemiology, etiology, pathogenesis, clinical manifestations, differential diagnosis, and management of IE in children. Some key points include: congenital heart disease is the most common risk factor; viridans streptococci and staphylococci are frequent causes; clinical features can include fever, heart failure, and neurological symptoms; and diagnosis involves considering other conditions like sepsis, myocarditis, or rheumatologic disorders.
This document provides an overview of infective endocarditis, including its definition, epidemiology, anatomy, pathogenesis, classification, etiology, risk factors, clinical manifestations, diagnosis, management, and complications. Infective endocarditis is a bacterial or fungal infection of the heart valves or endocardium. It most commonly affects the mitral valve and is usually caused by streptococci, staphylococci, or enterococci. It can be acute or subacute and is diagnosed using the modified Duke criteria.
Endocarditis is an inflammatory process of the inner lining of the heart. Bacteria enter the bloodstream and colonize on heart valves, forming clots and vegetations that can damage valves and embolize to other organs. Symptoms are non-specific but may include fever, heart murmur, petechiae, splinter hemorrhages, and signs of infection in other organs. Treatment involves intravenous antibiotics for 4 weeks or more. Nursing care focuses on monitoring for signs of infection, complications affecting organs, and managing symptoms like fever while the patient completes the long antibiotic regimen.
This document outlines a presidential action plan for infectious endocarditis in children. It begins with definitions of infective endocarditis and discusses the epidemiology, pathogenesis, clinical features, diagnosis, treatment and prevention. Key points include that infective endocarditis is less common in children than adults but is increasing in those with cardiac surgery or conditions. Common causes are streptococcal and staphylococcal species. Clinical features may include fever, heart murmur and embolic phenomena. Echocardiography is important for diagnosis but blood cultures are also needed under the modified Duke criteria. Surgery may be indicated for complications such as heart failure or abscesses.
This document provides an overview of infective endocarditis (IE), including its introduction, classification, pathogenesis, clinical manifestations, diagnosis, and treatment. Some key points:
- IE is defined as an infection of the inner lining of the heart (endocardium) that can involve heart valves, the inner lining of the heart chambers, or defects in the heart wall.
- It is classified based on temporal evolution (acute vs. subacute) and location (native valve, prosthetic valve, device-related, right-sided). Common causes include streptococci, staphylococci, and enterococci.
- Diagnosis is based on the Modified Duke Criteria, which considers
Endocarditis is an infection of the inner lining of the heart (endocardium). It is usually caused by bacteria or fungi entering the bloodstream from another part of the body. Common symptoms include fever and heart murmur. Diagnosis involves blood tests, echocardiogram, and blood cultures. Treatment requires long-term antibiotics and may require surgery to replace damaged heart valves. Complications can include heart failure, stroke, kidney damage, and embolisms in other parts of the body.
This document discusses congestive heart failure in children. It defines CHF as the heart's inability to meet metabolic demands due to reduced cardiac output or inability to dispose of venous return. Key factors affecting cardiac performance are preload, afterload, and contractility. Compensatory mechanisms in heart failure involve cardiac, systemic, and neurohormonal responses. Etiologies of pediatric CHF include congenital heart defects, cardiomyopathies, and acquired conditions. The document outlines approaches to diagnosis, treatment including medications to reduce preload and afterload, and non-pharmacological options.
This document discusses acute kidney injury (AKI), including its definition, diagnosis criteria, epidemiology, classification, pathogenesis, etiology, treatment, and management. AKI is defined as an abrupt reduction in kidney function, diagnosed by changes in serum creatinine, BUN, and urine output. Between 5-7% of hospitalized patients and a greater percentage of ICU patients develop AKI. Mortality from AKI exceeds 50% despite improvements in care. AKI is classified using criteria like RIFLE, AKIN, and KDIGO which consider risk, injury, failure, and loss of kidney function. Causes include prerenal issues like dehydration, intrinsic renal damage, and postrenal obstruction
Myocarditis is an inflammatory disease of the heart muscle that can be caused by infectious or non-infectious triggers. It has a variable clinical presentation ranging from mild symptoms to life-threatening cardiogenic shock. Diagnosis is challenging but can involve elevated cardiac biomarkers, ECG abnormalities, echocardiogram findings of ventricular dysfunction, and cardiovascular MRI or endomyocardial biopsy showing inflammatory infiltrates. Treatment focuses on managing heart failure symptoms and arrhythmias with medications like diuretics, ACE inhibitors, beta-blockers, and avoiding digoxin in acute heart failure. The prognosis varies from complete recovery to chronic dilated cardiomyopathy or sudden death.
This document provides an overview of infective endocarditis, including its definition, pathogenesis, epidemiology, clinical presentation, diagnosis, and treatment. It defines infective endocarditis as a microbial infection of the heart valves or endocardium. It discusses the typical pathogens involved and describes the formation of vegetations on heart valves. It also outlines the diagnostic criteria, including blood cultures and echocardiography. Treatment involves prolonged antibiotic therapy tailored to the causative organism, and may require surgery in cases of heart failure or uncontrolled infection.
Definition, classification, epidemiology, etiology, diagnosis, prognosis of DCM, HOCM, LVNC
Also review of acute myocarditis in children
R/v of heart failure management
This document discusses heart failure in children, including its definition, types, causes, symptoms, diagnosis, complications, and management. Heart failure occurs when the heart cannot pump enough blood to meet the body's needs. In children, common causes include congenital heart disease, rheumatic heart disease, and cardiomyopathy. Symptoms vary by age but may include feeding issues, sweating, poor growth, and edema. Diagnosis involves exams, chest x-rays, electrocardiograms, and echocardiograms. Complications can include arrhythmias, infections, and damage to other organs. Treatment focuses on supportive care, medications to improve heart function, and treating the underlying cause. Prognosis depends on the cause,
This document discusses heart failure in children. It defines heart failure as the heart's inability to pump enough blood to meet the body's needs. The key factors that affect cardiac performance are preload, afterload, and contractility. In children, common causes of heart failure include congenital heart defects, cardiomyopathy, and acquired conditions like myocarditis. Symptoms depend on whether left-sided or right-sided heart failure predominates. Treatment focuses on correcting underlying causes, diet modification, diuretics to reduce preload, digitalis to improve contractility, and dilators to reduce afterload. Imaging studies like echocardiograms are important for diagnosis.
Acute kidney injury (AKI), formerly known as acute renal failure, is defined as a sudden deterioration of kidney function resulting in the inability to maintain fluid and electrolyte homeostasis. It can be caused by prerenal issues affecting blood flow to the kidneys, intrinsic renal parenchymal damage, or postrenal urinary tract obstruction. The incidence of AKI varies globally and it commonly occurs in critically ill children with coexisting conditions. Etiologies include pre-renal causes like decreased intravascular volume, intrinsic renal diseases affecting glomeruli or tubules, and post-renal obstruction. Diagnosis involves lab tests of kidney and liver function as well as imaging studies. Treatment focuses on fluid management, electrolyte
Acute poststreptococcal glomerulonephritis (APSGN) is characterized by sudden edema, hematuria, proteinuria, and hypertension 1-4 weeks after a streptococcal infection. Histologically, there is diffuse proliferation of glomerular cells and leukocytes. It is caused by immune complexes forming in response to certain M protein serotypes of streptococcus. On microscopy, there are subepithelial immune deposits, complement activation, and inflammation, appearing as "humps". Patients typically experience malaise, fever, nausea, and hematuria after a sore throat. Laboratory findings include elevated antibody titers and low complement levels. Most children fully recover with conservative care, while a small percentage progress
Infective endocarditis is an infection of the inner lining of the heart chambers and heart valves. It has an incidence of about 1 in 1,000 hospital admissions and risks include structural heart disease, immunosuppression, pacemakers, prolonged cardiac surgery, intravenous drug use, and nosocomial infections. Clinical presentations can be acute with toxicity and metastatic infection developing over days to weeks, or subacute progressing over weeks to months with less toxicity. Complications include heart failure, abscesses, and embolism, with an overall mortality rate of 10-20%. Treatment involves antibiotics tailored to the infecting organism and surgery may be required in some cases.
This document provides information about endocarditis, including:
- Endocarditis is an inflammation of the inner lining of the heart and heart valves. It is commonly caused by a heart valve infection from microorganisms entering the bloodstream.
- It is classified as either acute or subacute based on symptoms and causative organisms. Common causative organisms include streptococci, staphylococci, and enterococci.
- Risk factors include age over 50, pre-existing heart conditions, IV drug use, and dental procedures. Diagnosis involves blood cultures, echocardiogram, and application of the Modified Duke Criteria. Treatment involves antibiotics targeting the causative organism along with possible surgery
The document discusses cardiogenic shock, which results from inadequate tissue perfusion due to cardiac dysfunction. Cardiogenic shock is defined by a sustained systolic blood pressure below 90 mm Hg, cardiac index below 2.2 L/min/m2, and pulmonary capillary wedge pressure above 15 mm Hg. Causes of cardiogenic shock include acute myocardial infarction, mechanical complications, right ventricular infarction, and other conditions such as cardiomyopathy. The pathophysiology and management of cardiogenic shock are discussed.
This document discusses myocarditis in children. It defines myocarditis and describes the epidemiology, etiology, pathophysiology, clinical presentation, diagnosis and treatment. Myocarditis has many potential causes including viruses like adenovirus and enterovirus. Clinically it presents variably depending on age from nonspecific symptoms to heart failure. Diagnosis involves blood tests, ECG, imaging like echocardiogram and cardiac MRI, and endomyocardial biopsy. Treatment is supportive with heart failure medications, antivirals may help, and immunosuppressants can reduce inflammation and improve function.
This document provides information about infective endocarditis, including its causes, risk factors, clinical manifestations, diagnosis, treatment, nursing care, and prevention. Infective endocarditis is an infection of the heart valves and lining that can be caused by bacteria or fungi entering the bloodstream. It requires long-term antibiotic treatment and may necessitate valve replacement surgery if complications occur. Nurses monitor for symptoms, assess treatment effectiveness, and educate patients on preventing future infections.
This document outlines a lecture on pediatric infective endocarditis. It discusses the epidemiology, etiology, pathogenesis, clinical manifestations, differential diagnosis, and management of IE in children. Some key points include: congenital heart disease is the most common risk factor; viridans streptococci and staphylococci are frequent causes; clinical features can include fever, heart failure, and neurological symptoms; and diagnosis involves considering other conditions like sepsis, myocarditis, or rheumatologic disorders.
This document provides an overview of infective endocarditis, including its definition, epidemiology, anatomy, pathogenesis, classification, etiology, risk factors, clinical manifestations, diagnosis, management, and complications. Infective endocarditis is a bacterial or fungal infection of the heart valves or endocardium. It most commonly affects the mitral valve and is usually caused by streptococci, staphylococci, or enterococci. It can be acute or subacute and is diagnosed using the modified Duke criteria.
A powerpoint presentation about infective Endocarditis, with the most recent updates from the most reliable sources. I highlighted an introduction, pathology, approach to disease & different management plans in this presentation. 2018. Please don't forget to give me credit to my work.
This document discusses a case of infective endocarditis in a 6-year-old female child presenting with fatigue, joint pain, fast breathing, and other symptoms. After examination and testing, vegetative mass was discovered on the septal tricuspid valve. The child was diagnosed with tricuspid valve infective endocarditis. The document then provides definitions, classifications, clinical features, diagnostic criteria, management guidelines, and complications of infective endocarditis in children. It emphasizes the importance of blood cultures, echocardiography, and long-term antibiotic treatment along with monitoring for complications like embolism.
This document discusses infective endocarditis (IE), including its changing epidemiology, pathogenesis, clinical manifestations, diagnosis, complications, and management. Some key points:
- The median age of IE patients has increased to over 60 years old. Rheumatic heart disease is less common while intracardiac devices and nosocomial sources have risen.
- Vegetations form from platelet-fibrin deposition on damaged heart valves, allowing bacterial colonization and abscess formation.
- Echocardiography is important for diagnosis. Findings include vegetations, abscesses, and valve dysfunction. Blood cultures help identify causative organisms.
- Complications include heart failure, embolization, and periannular
Infective endocarditis is an infection of the heart valves or endocardium. It has variable presentations ranging from acute and rapidly progressive to subacute and indolent. Key diagnostic criteria include identifying the infecting pathogen through blood cultures or other tests and detecting valvular vegetations or complications through echocardiography. Complications can involve the heart, brain, kidneys and other organs due to septic emboli. Treatment involves antibiotics and may require cardiac surgery.
This document discusses infective endocarditis (IE), a serious infection of the heart valves or inner lining of the heart. It provides details on the epidemiology, symptoms, physical exam findings, causative organisms, risk factors, diagnostic criteria (Modified Duke Criteria), investigations including echocardiography and blood cultures, and treatment approach for IE. Staphylococcus aureus is a leading cause worldwide and viridans group streptococci are common causes after dental procedures. Diagnosis relies on modified Duke criteria incorporating positive blood cultures, echocardiogram findings, and clinical features.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by the formation of vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. Streptococci and Staphylococcus aureus are the most common causes. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, heart failure, and metastatic infections. Treatment involves prolonged antibiotic therapy targeted to the infecting organism. Surgery may be needed for complications or uncontrolled infection. Antibiotic prophylaxis is now restricted to highest risk patients undergoing highest risk procedures.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by the formation of vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. Streptococci and Staphylococcus aureus are the most common causes. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, heart failure, and metastatic infections. Treatment involves prolonged antibiotic therapy targeted to the infecting organism. Surgery may be needed for complications or uncontrolled infection. Antibiotic prophylaxis is now restricted to highest risk patients undergoing highest risk procedures.
This document provides an overview of infective endocarditis. It begins with definitions and epidemiology. Risk factors include age over 60, injection drug use, poor dental health, male sex, and underlying heart conditions. Common causative organisms are staphylococci, streptococci, and enterococci. Diagnosis is based on the modified Duke criteria using blood cultures, echocardiography, and clinical features. Treatment involves antibiotic therapy for 4-6 weeks based on identified organisms, with a focus on obtaining negative follow up blood cultures. Prognosis depends on the causative organism and underlying heart condition.
This document provides information about infective endocarditis:
- Infective endocarditis involves infection of the heart valves and inner lining of the heart. Common causes are bacteria entering the bloodstream from dental, respiratory, or other procedures.
- The infection can cause growths (vegetations) on the heart valves that can break off and block blood vessels in the brain, lungs, kidneys or other organs.
- Risk factors include previous heart damage, dental and surgical procedures, and some reproductive or congenital conditions. Investigations include blood tests, cultures, ECG and echocardiography. Complications may require surgery to repair or replace damaged valves.
Infective endocarditis is an infection of the heart valves or inner lining of the heart that is usually caused by bacteria entering the bloodstream. It can cause inflammation of the heart valves and formation of vegetations, which can lead to heart failure, embolic episodes, or death if not treated properly with antibiotics and sometimes surgery. The document discusses the definition, causes, clinical presentation, diagnosis, and treatment of infective endocarditis.
Infective endocarditis is a condition where the inner lining of the heart (endocardium) becomes infected by bacteria or other microorganisms. It typically occurs where there is pre-existing heart valve damage. The infection can cause heart valve damage and formation of clumps (vegetations) that can break off and spread through the bloodstream (embolize). Presentation depends on the causative organism and can range from non-specific fever to new heart murmurs or signs of embolization. Diagnosis is based on blood cultures and echocardiography, while treatment involves prolonged antibiotic therapy and may require heart valve replacement surgery. Risk factors include rheumatic or congenital heart disease, prosthetic heart
This document outlines a presidential action plan for infective endocarditis in children. It discusses the definition, epidemiology, pathogenesis, clinical features, diagnosis, and treatment. Key points include that infective endocarditis most commonly affects children with congenital heart disease and involves native or prosthetic heart valves. Common causative organisms are streptococci, enterococci, and staphylococcus aureus. Diagnosis is based on modified Duke's criteria including positive blood cultures, echocardiographic findings, and clinical criteria. Treatment involves long-term antibiotic therapy.
This document summarizes the key aspects of infective endocarditis:
1) Infective endocarditis occurs when bacteria infect the heart valves or endocardial surface. The causes and patients affected have changed over time, with older patients and those with medical devices now more commonly affected.
2) Staphylococci such as S. aureus are now the most common causes, rather than streptococci. Mortality remains high at 30% despite advances in diagnosis and treatment.
3) Clinical presentation is varied and non-specific, ranging from fever to sepsis or embolic complications. Echocardiography is important for diagnosis. Treatment involves long-term antibiotics, with surgery as needed,
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by pathological vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. It can be acute, affecting normal valves rapidly, or subacute, often affecting damaged valves in a slower manner. Bacteria enter the bloodstream and attach to platelet-fibrin deposits on damaged heart valves. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, local or metastatic infection spread, and immune complex disease. Treatment involves antibiotics, sometimes with surgery. High-risk patients may receive antibiotic prophylaxis
Diagnosis and Management of Infective Endocarditis
Modified Dukes Criteria
Imaging Modalities
Standard Treatment Guidelines
Organism Specific Antibiotic coverage
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3. Introduction
Is an infection of the
endocardium and/or heart valves that
involves thrombus formation
(vegetation), which may damage the
endocardial tissue and/or valves.
Bacteria are the predominant
microbial pathogens
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4. Nonbacterial endocarditis can be
caused by viruses, fungi, and other
microbiologic agents.
It is a significant cause of morbidity
and mortality in children and
adolescents despite advances in the
management and prophylaxis of the
disease with antimicrobial agents.
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5. Native or prosthetic heart valves are
the most frequently involved sites.
Endocarditis also can involve septal
defects, the mural endocardium, or
intravascular foreign devices such as
intracardiac patches, surgically
constructed shunts, and intravenous
catheters.
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6. Infective endarteritis is a similar
clinical illness involving arteries,
including the ductus arteriosus, the
great vessels, aneurysms, or
arteriovenous shunts.
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7. EPIDEMIOLOGY
The prevalence of definite IE was
approximately 12%, and definite or
possible IE was 20%.
About 35-50% of children with IE have
CHD.
The risk of IE is increased in patients
with complex cyanotic heart disease,
especially in those who undergo
surgical procedures
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8. The cumulative incidence of IE over
25 years following surgery was
determined for the following CHD
defects.
Valvular aortic stenosis — 13.3%
Coarctation of the aorta — 3.5%
Primum atrial septal defect — 2.8%
Ventricular septal defect (VSD) — 2.7%
Tetralogy of Fallot (TOF) — 1.7%
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9. ETIOLOGIES
Gram-positive cocci account for about
90% of recoverable bacteria( Adult
studies)
Viridans-type streptococci (α-hemolytic
streptococci) and S.aureus remain the
leading causative agents.
Staphylococcal endocarditis is more
common in patients with no underlying
heart disease.
viridans group streptococcal infection is
more common after dental procedures.
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10. Group D enterococci are seen more
often after lower bowel or
genitourinary manipulation.
P.aeruginosa or S.marcescens is seen
more frequently in intravenous drug
users.
Fungal endocarditis – one of the most
feared forms (complications, like
embolization are common)
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11. Fungal organisms are encountered
after open heart surgery.
Coagulase-negative staphylococci are
common in the presence of an
indwelling central venous catheter.
Gram-negative organisms cause
<10% of the endocarditis in children.
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12. Approximately 5% -10% of patients
with endocarditis have negative blood
cultures.
The most common cause of culture-
negative IE is current or recent
antibiotic therapy or infection caused
by a fastidious organism that grows
poorly in vitro.
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13. Pathogenesis
Turbulent flow traumatizes the
vascular endothelium, creating a
substrate for deposition of fibrin and
platelets, leading to the formation of a
nonbacterial thrombotic embolus
(NBTE).
Biofilms form on the surface of
implanted mechanical devices such as
valves, catheters, or pacemaker wires
that also serve as the adhesive
substrate for infection.
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14. The development of transient
bacteremia then colonizes this NBTE
or biofilm, leading to proliferation of
bacteria within the lesion.
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15. Occurrence of transient bacteremia
Adherence of bacteria to the NBTE
Proliferation of bacteria with in the
vegetation
Large fibrin deposit encase the bacteria
inside
Prevent phagocytosis and anti-microbial
penetration
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16. Virtually all vegetations occur in areas
where there is a pressure gradient with
resulting turbulence of blood flow.
The sites of high-velocity jets where
most IE vegetations occur are on the
atrial side of the atrioventricular valves
and the ventricular side of the semilunar
valves.
In ≈30% of patients with infective
endocarditis, a predisposing factor is
presumably recognized.
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17. Relative risk of IE for underlying
cardiac lesions & conditions
High risk:
prosthetic valves
Previous episode of endocarditis
Complex cyanotic congenital heart
diseases (e.g. single ventricle states,
TGA, TOF)
Surgically corrected systemic artery to
pulmonary artery shunts
Injection drug use
Indwelling central venous catheters
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29. DIAGNOSIS
Blood culture
Three to 5 separate blood collections
should be obtained.
The timing of collections is not
important because bacteremia can be
expected to be relatively constant.
In 90% of cases of endocarditis, the
causative agent is recovered from the
first 2 blood cultures
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30. Usually 20 to 30 mL of blood is collected
from an adult patient, but this is not
possible in a small child.
Thus 1 to 3 mL in infants and young
children and 5 to 7 mL in older children
are optimal.
Usually, three blood cultures are
obtained by separate venipunctures on
the first day, and if there is no growth by
the second day of incubation, two more
may be obtained. 8/28/2020 30IE
31. Antimicrobial pretreatment of the patient
reduces the yield of blood cultures to 50-
60%
Echocardiography
◦ evidence of valve vegetations,
◦ prosthetic valve dysfunction or leak,
◦ myocardial abscess,
◦ new-onset valve insufficiency
◦ predicting embolic complications( fungating
mass >1cm in size)
◦ sensitivities in children reported to be >80%
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32. Other laboratory findings
Elevated erythrocyte sedimentation rate; may be low
with heart or renal failure
Elevated C-reactive protein
Anemia
Leukocytosis
Immune complexes
Hypergammaglobulinemia
Hypocomplementemia
Rheumatoid factor
Hematuria
Renal failure: azotemia, high creatinine
(glomerulonephritis)
Chest radiograph: bilateral infiltrates, nodules, pleural
effusions
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33. Duke crteria
Major criteria
1) positive blood cultures (2 separate
cultures for a usual pathogen, 1 or more
for less-typical pathogens), and
2) evidence of endocarditis on
echocardiography
-intracardiac mass on a valve or other site
-regurgitant flow near a prosthesis
-abscess
-partial dehiscence of prosthetic valves, or
- new valve regurgitant flow
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34. Minor criteria
Predisposing conditions,
fever,
Embolic-vascular signs,
Emmune complex phenomena
(glomerulonephritis, arthritis, rheumatoid
factor, Osler nodes, Roth spots),
A single, positive blood culture or
Serologic evidence of infection, and
Echocardiographic signs not meeting the
major criteria.
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35. clubbing,
splenomegaly,
splinter hemorrhages,
petechiae
a high erythrocyte sedimentation rate
a high C-reactive protein level
the presence of central nonfeeding
lines, peripheral lines,
microscopic hematuria
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36. Definite infective endocarditis (IE):
Pathologic criteria:
◦ Micro-organisms demonstrated by culture or
histologic examination of a vegetation, a
vegetation that has embolized, or an intracardiac
abscess specimen; or
◦ Pathological lesions; vegetation or intracardiac
abscess confirmed by histologic examination
showing active endocarditis
Clinical criteria :
◦ 2 major criteria; or
◦ 1 major criterion and 3 minor criteria; or
◦ 5 minor criteria
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37. Possible IE:
◦ 1 major criterion and 1 minor criterion; or
3 minor criteria
Rejected IE:
◦ Firm alternative diagnosis explaining
evidence of IE; or
◦ Resolution of IE syndrome with antibiotic
therapy for 4 days; or
◦ No pathologic evidence of IE at surgery or
autopsy, with antibiotic therapy for 4 days; or
◦ Does not meet criteria for possible IE as
above
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41. treatment
Antimicrobial
General principles
◦ Prolonged periods of treatment(4 to 6
weeks)
◦ Bacteriocidal rather than bacteriostatic
◦ Parentral antibiotic
◦ High dose
◦ Combination of antibiotic which have
synergistic effect
◦ Managed in hospital initialy
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42. Antibiotic therapy should be instituted
immediately once a definitive
diagnosis is made.
outpatient therapy can be undertaken
if the patient is afebrile, has negative
blood cultures, and is at negligible
risk for complications.
Empiric therapy should cover
staphylococci, streptococci, and
enterococci.
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43. Most patients with IE become afebrile
5-6 days after treatment is begun with
an appropriate antibiotic.
Patients with S. aureus endocarditis
may respond somewhat more slowly,
remaining febrile for 5-7 days after the
institution of therapy
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44. The initial microbiologic response to
therapy should be assessed by
obtaining repeat blood cultures 48 -72
hours after antibiotics are begun.
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45. Surgical management
INDICATIONS
◦ Severe aortic, mitral or prosthetic valve
involvement with intractable heart failure.
◦ Mycotic aneurysm
◦ Rupture of an aortic sinus
◦ Intraseptal abscess causing complete
heart block
◦ Dehiscence of an intracardiac patch
◦ Fungal endocarditis
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46. ◦ Failure to sterilize the blood despite
adequate antibiotic levels in 7-10 days
◦ Increasing size of vegetations while
receiving therapy.
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48. CONGENITAL HEART DISEASE
(CHD)
Unrepaired cyanotic CHD
Completely repaired CHD with
prosthetic material or device during
the 1st 6 mo after the procedure
Repaired CHD with residual defects
Cardiac transplantation recipients who
develop cardiac valvulopathy.
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49. reference
Nelson 20th edition
Moss and Adams cardiology 7th edition
Uptodate 20.2
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