infective endocarditis

Mind Map by , created over 5 years ago

Paediatrics (Cardio) Mind Map on infective endocarditis, created by v.djabatey on 01/29/2014.

Created by v.djabatey over 5 years ago
PHSI3011 07-1 Cardiorespiratory adaptation to high altitude
Michael Jardine
Cystic fibrosis
B6 - Brain and Mind OCR
1PR101 2.test - Část 14.
Nikola Truong
Chapter 11: Cardiorespiratory Training: Programming and Progressions
Histology of Heart and Blood Vessels
Hannah Tribe
Stroke (Lectures I & II)
Matthew Coulson
Child development
Cardiorespiratory system
infective endocarditis
1 risk of IE
1.1 in kids of any age w/ congenital heart disease
1.1.1 except those w/ secundum ASD
1.2 risk highest where there is turbulent jet of blood
1.2.1 VSD
1.2.2 coarctation of aorta
1.2.3 persistent ductus arteriosus
1.2.4 surgical insertion of prosthetic stuff
2 be highly suspicious!
2.1 any child/adult w/
2.1.1 sustained fever
2.1.2 malaise
2.1.3 raised ESR
2.1.4 unexplained anaemia
2.1.5 haematuria
2.2 don't rely on presence of classical physical stigmata for diag
3 clinical signs
3.1 fever
3.2 anaemia & pallor
3.3 splinter haemorrhages in nailbed
3.4 clubbing (late)
3.5 necrotic skin lesions
3.6 changing cardiac signs
3.7 splenomegaly
3.8 neuro signs from cerebral infarction
3.9 retinal infarcts
3.10 arthritis/arthralgia
3.11 haematuria (microscopic)
4 diagnosis
4.1 multiple blood cultures should be taken
4.1.1 before Abx started
4.2 detailed cross sec echo
4.2.1 confirm diag by IDing vegetations but can never exclude IE vegetations made of fibrin & platelets contain pathogen
4.3 raised acute phase reactants
4.3.1 useful to monitor response to Rx
5 alpha haemolytic strep (strep viridans)
5.1 commonest causative organism
6 Rx
6.1 penicillin+ aminoglycoside
6.1.1 6 weeks therapy
6.1.2 check serum Abx level will kill pathogen
6.2 if infected prosthetic material present
6.2.1 surgical removal may be needed
7 prophylaxis
7.1 good dental hygiene
7.1.1 most imp factor
7.1.2 must strongly encourage in kids w/ congenital heart disease
7.2 Abx prophylaxis
7.2.1 no longer recommended in UK
7.2.2 may be needed in other countries for any dental Rx surgery, which is likely to be assoc w/ bacteraemia

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