Professional Documents
Culture Documents
Streptococcus pneumoniae
Haemophilus influenzae
Coagulage-negative staphylococci
Coxiella burnetii (Q fever)[*]
Neisseria gonorrhoeae
Brucella[*]
Chlamydia psittacli[*]
Chlamydia trachomatis[*]
Chlamydia pneumoniae[*]
Legionella[*]
Bartonella[*]
HACEK group[]
Streptobacillus moniliformis[*]
Pasteurella multocida[*]
Campylobacter fetus
Culture negative (6% of cases)
Staphylococcus epidermidis
Staphylococcus aureus
Viridans group streptococcus
Pseudomonas aeruginosa
Serratia marcescens
Diphtheroids
Legionella species[*]
HACEK group[]
Fungi[]
Pre-existing congenital/acquired heart disease
Legend:
++++ very common ++ infrequent
+++ in most cases + rare
Finding Frequency
Laboratory
Positive blood culture (off antibiotics) ++++
Elevated acute phase reactants ++++
Anemia +++
Hematuria +++
Presence of rheumatoid factor ++
Leukocytosis ++
Legend:
++++ very common
+++ in most cases
++ Infrequent
+ rare
new or changing murmurs are usually heard
- Frequent auscultation is essential
Patients with suspected embolic events are
candidates for serial echo to localize vegetations
and to define changes that may occur with time
Splenomegaly may be present in a majority of
instances when the disease has been present for
weeks or months
Neurologic findings are present in 20% of children
and may simulate the picture of an abscess,
infarct or aseptic meningitis
most valuable tool
Collection of 2 or 3 samples over a 24 hr period is adequate in
most cases
o (+) blood culture
o Evidence of endocarditis on echocardiography
A. Positive echocardiogram for IE defined as:
i. Oscillating intracardiac mass on valve or supporting
structures, in the path of regurgitant jets, or an implanted
material in the absence of an alternative anatomic
explanation or
ii.Abscess, or
iii.New partial dehiscence of prosthetic valve or
B. New valvular regurgitation (worsening or changing of
preexisting murmur)
Minor criteria
Predisposition: predisposing heart condition or intravenous drug use
Microbiological evidence: positive blood culture but does not meet a major criterion
as noted above or serological evidence of active infection with organism consistent
with IE
aCephalosporins should not be used in individuals with immediate-type hypertensivity reaction (urticaria,
angioedema, or anaphylaxis) to penicillins.
Definition:
An auto immune disease preceded by GABS
Generalized disease affecting all the connective tissues of
the body
Characterized by periods of exacerbation
Commonly affects 6-15 years old
Major Criteria
1. Arthritis
2. Carditis
3. Erythema Marginatum
4. Subcutaneous nodules
5. Chorea
Minor Criteria
Clinical Laboratory
Fever
ASO
Arthralgia (joint
ESR
pains w/o CRP
objective WBC
findings) pr interval
2major
1major + 2minor
Mitral valve insuficiency
pathophysiology
Clinical
manifestation
complications
Mitral valve stenosis
pathophysiology
Clinical
manifestation
complications
Aortic Insufficiency
pathophysiology
Clinical
manifestation
complications
Tricuspid Insufficiency
pathophysiology
Clinical
manifestation
complications
pulmonic Insufficiency
Diseases of the myocardium
primary vs. secondary
Classification:
o Dilated
o Hypertrophic
o Restrictive
Accumulation of fluid in the pericardial space
Tamponade
Clinical Manifestations
o Precordial pain- sharp, stabbing pain radiating to the Left shoulder and
back
o Friction rub
o Pulsus paradoxus
Diagnosis
o Echocardiogram
o ECG
Low voltage QRS
T wave inversion
Electrical alternans
Constrictive pericarditis