70 Questions
Which of the following is true about infective endocarditis (IE)?
IE is caused by a bacterial infection
Which valves are at risk in infective endocarditis?
Aortic valve and mitral valve
What are the factors causing bacteraemia, which can potentially lead to infective endocarditis?
Poor dental hygiene and intravenous drug use
Which group of bacteria is an unusual cause of infective endocarditis?
HACEK organisms
What is the most common peripheral sign of infective endocarditis?
Petechiae
Which lab investigation is almost always elevated in infective endocarditis?
ESR
What is the recommended duration of antibiotic treatment for infective endocarditis caused by oral streptococci?
4 weeks
Which of the following is NOT a complication of infective endocarditis?
Pulmonary manifestations
Which of the following is the leading indication for surgery in infective endocarditis?
Congestive heart failure
When is antibiotic prophylaxis recommended for patients at highest risk of infective endocarditis?
Before dental procedures only
What is the recommended antibiotic prophylaxis regimen for high-risk patients undergoing dental procedures?
Ampicillin 2g IV/IM + GM 1.5mg/kg (pre-30 min), Ampicillin 1g IV/IM or Amoxicillin 1g po (post-6 hour)
Which of the following is the most common cause of acute native valve endocarditis?
Staphylococcus aureus
Which of the following is the most common cause of subacute native valve endocarditis?
Alpha-hemolytic streptococci
Which of the following conditions is NOT associated with an increased risk of prosthetic valve endocarditis?
Rheumatic heart disease
Which group of bacteria is responsible for the majority of cases of infective endocarditis?
Staphylococci
Which of the following is the recommended antibiotic treatment for infective endocarditis caused by methicillin-sensitive Staphylococcus aureus (MSSA)?
Nafcillin or oxacillin
What is the most common peripheral sign of infective endocarditis?
Splinter hemorrhages
Which of the following is NOT a complication of infective endocarditis?
Pulmonary embolism
Which of the following is a complication of infective endocarditis that occurs in over half of all cases?
CNS and Peripheral Ischemic infarcts
Which of the following is the most common cause of ischemic infarcts in infective endocarditis?
Septic emboli with secondary arteritis
Which of the following is the leading cause of mortality in infective endocarditis?
Congestive Heart Failure
When is surgery strongly indicated in infective endocarditis?
When congestive heart failure develops
Which of the following is the most common cause of subacute native valve endocarditis?
Streptococcus viridans
Which of the following conditions is NOT associated with an increased risk of prosthetic valve endocarditis?
Rheumatic heart disease
What is the leading cause of mortality in infective endocarditis?
Septic shock
Which of the following is the most common complication of infective endocarditis?
CNS and peripheral ischemic infarcts
Which of the following is the leading cause of mortality in infective endocarditis?
Congestive heart failure
When is surgery strongly indicated in infective endocarditis?
When there is valvular dysfunction
What is the recommended duration of antibiotic treatment for infective endocarditis?
4-6 weeks
Which of the following is NOT a risk factor for prosthetic valve endocarditis?
Rheumatic heart disease
Which of the following is the most common cause of acute native valve endocarditis?
Staphylococcus aureus
Which of the following is the most common complication of infective endocarditis?
Embolic events
Which group of bacteria is an unusual cause of infective endocarditis?
HACEK organisms
Which of the following is NOT a complication of infective endocarditis?
Fungal infection
What is the recommended antibiotic treatment for infective endocarditis caused by methicillin-resistant Staphylococcus aureus (MRSA)?
Vancomycin
What is the most common cause of culture negative endocarditis?
Recent use of antibiotics
Which of the following is NOT a common peripheral sign of infective endocarditis?
Osler's nodes
Which of the following organisms is NOT a member of the HACEK group?
Staphylococcus
Which of the following is NOT a major criterion for the diagnosis of infective endocarditis according to the Duke Criteria?
Fever
Which of the following is NOT a principle of therapy for infective endocarditis?
Plan for short courses of antibiotics
Which of the following is NOT a complication of infective endocarditis?
Glomerulonephritis
Which of the following is the most common cause of ischemic infarcts in infective endocarditis?
Septic emboli
When is surgery strongly indicated in infective endocarditis?
When congestive heart failure develops
When is antibiotic prophylaxis recommended for patients at highest risk of infective endocarditis?
Before dental procedures
Which of the following is NOT a common clinical feature of infective endocarditis?
Enlargement of spleen
Which of the following is the most common cause of culture negative endocarditis?
Recent use of antibiotics
Which of the following is NOT a peripheral manifestation of infective endocarditis?
Clubbing
Which of the following is the most common organism responsible for infective endocarditis?
Streptococcus aureus
Which of the following is the most common cause of acute native valve endocarditis?
Staphylococcus aureus
Which of the following conditions is NOT associated with an increased risk of prosthetic valve endocarditis?
Rheumatic heart disease
What is the recommended duration of antibiotic treatment for infective endocarditis caused by oral streptococci?
6 weeks
Which of the following is NOT a complication of infective endocarditis?
Hemorrhagic complications
When is antibiotic prophylaxis recommended for patients at highest risk of infective endocarditis?
Before dental procedures
Which group of bacteria is an unusual cause of infective endocarditis?
Mycobacterium tuberculosis
What is the recommended duration of antibiotic treatment for infective endocarditis caused by oral streptococci?
4-6 weeks
Which of the following is a common peripheral sign of infective endocarditis?
Clubbing
Which of the following is NOT a major criterion for the diagnosis of infective endocarditis according to the Duke Criteria?
New valvular regurgitation
Which group of bacteria is responsible for the majority of cases of infective endocarditis?
Streptococci
What is the recommended duration of antibiotic treatment for infective endocarditis caused by oral streptococci?
6 weeks
Which of the following is the most common cause of acute native valve endocarditis?
Staph aureus
Which of the following is NOT a risk factor for prosthetic valve endocarditis?
Rheumatic heart disease
What is the most common peripheral sign of infective endocarditis?
Splinter hemorrhages
Which of the following is the most common complication of infective endocarditis?
Embolism
When is surgery strongly indicated in infective endocarditis?
When congestive heart failure develops
Which group of bacteria is responsible for the majority of cases of infective endocarditis?
Staphylococcus aureus
When is antibiotic prophylaxis recommended for patients at highest risk of infective endocarditis?
Before dental procedures
Which of the following is NOT a common peripheral sign of infective endocarditis?
Clubbing
Which of the following is the most common cause of acute native valve endocarditis?
Staphylococcus aureus
Which of the following is NOT a major criterion for the diagnosis of infective endocarditis according to the Duke Criteria?
Positive blood culture
Which of the following conditions is NOT associated with an increased risk of prosthetic valve endocarditis?
Mitral valve prolapse
Study Notes
Infective Endocarditis
- Infective endocarditis (IE) can affect any heart valve, but mitral and aortic valves are most commonly affected.
- Bacteraemia, which can lead to IE, can be caused by factors such as indwelling IV lines, hemodialysis, and IV drug abuse.
- HACEK group of bacteria (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, and Kingella) are an unusual cause of IE.
Clinical Features and Diagnosis
- Roth's spots, Osler nodes, and Janeway lesions are common peripheral signs of IE.
- ESR is almost always elevated in IE.
- The leading indication for surgery in IE is heart failure.
Treatment and Prophylaxis
- The recommended duration of antibiotic treatment for IE caused by oral streptococci is 4-6 weeks.
- Antibiotic prophylaxis is recommended for high-risk patients undergoing dental procedures, and the recommended regimen is a single dose of amoxicillin 2g orally.
- Surgery is strongly indicated in IE when there is heart failure, perivalvular abscess, or persistently positive blood cultures.
Complications and Causes
- Heart failure is the leading cause of mortality in IE.
- Embolic events, such as ischemic infarcts, are a common complication of IE, and are most commonly caused by Staphylococcus aureus.
- Oral streptococci are the most common cause of subacute native valve endocarditis, while Staphylococcus aureus is the most common cause of acute native valve endocarditis.
Microbiology
- Staphylococcus aureus is responsible for the majority of cases of IE.
- Bartonella and Coxiella are unusual causes of IE.
Test your knowledge on Infective Endocarditis with this quiz! Learn about the definition, causes, and symptoms of this infection of the heart's endocardial surface. Challenge yourself with questions on acute and subacute bacterial endocarditis.
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