Download Infective Endocarditis

Predisposing factors

Underlying Heart Disease

Bacteremia, Septiceamia, Pyeamia
o
Congenital heart disease
Definition
o
Periodontal infection
o
Chronic rheumatic heart disease

Infection of heart valves or mural endocardial
o
GIT infection
o
Prosthetic heart valve

Resulting in the formation of vegetation consisting
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Surgery

Impaired host defense
o
Fibrin clot
o
Bacteria
Pattern
Acute Bacterial Endocarditis
Subacute Bacterial Endocarditis

Fulminant course

Caused by less virulent bacteria Strep viridans and HACEK,
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Destructive acute infection of Endocardium
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Affect diseased heart
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By virulent bacteria Staph aureus
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Last at least 6 weeks or more
Definition

Affect normal Heart
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Rapidly fatal within 2-6 weeks
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High grade fever
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Low grade fever
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Chill
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Weight loss
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Weakness
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Fatigue
Clinical Features
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Malaise
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Flu-like symptoms
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Cardiac murmurs
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Cardiac murmurs
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Friable

Non-friable/ firm
o
May form Embolism leading to

Less vulvular destrcution

Mycotic aneurysm
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No Ring Abcess formation

Septic infarct
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Non-suppurative
Gross

Abcess formation
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May spread to mural endocardium and myocardium forming Ring Abscess
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Suppurative
Eosinophilic substances consist of
Morphology
Outer Layer Cup

Fibrin
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Plateletes
Middle Basophilic Layer

Bacterial colony settlement
Microscopy
Acute Bacterial Endocarditis

No evidence of granulation tissue
Depper zone of Inflammation
Subacute Bacterial Endocarditis

Evidence pf granulation tissue
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Valves abnormalities

Myocardial abscess
o
Stenosis – Subacute

Suppurative endocarditis
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Insufficiency – Acute

Fistulous intracardiac connections
Cardiac

Perforatio, rupture and aneurysm of valve leaflet

Heart failure

Paravascular ring abcess
Complication

Embolism

Abcess

Nonspecific
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Left side chambers
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Right side chambers
o
Splinter heamorrhage

Septic infarct

Pulmonary infarct
o
Roths spot
Extracardiac

Mycotic aneurysm
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Jannaways spot
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Osler’s nodule

Janeway’s spots

Osler’s nodule
o
Painless
o
Painful
o
Non-tendor
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Tendor
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Located at
o
Located at
Signs and Symptoms

Palms

Palms
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Soles

Soles

Roth’s spot (retinal heamorrhage)

Focal necrotizing glomerulonephritis
Infective Endocarditis