infective endocarditis

v.djabatey
Mind Map by , created over 5 years ago

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

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v.djabatey
Created by v.djabatey over 5 years ago
leukaemia
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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
4.2.1.1 but can never exclude IE
4.2.1.2 vegetations made of fibrin & platelets
4.2.1.2.1 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
7.2.2.1 any dental Rx
7.2.2.2 surgery, which is likely to be assoc w/ bacteraemia

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