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Endocarditis - Overview and Differential Diagnosis Framework

Who?
Infectious:
• Pre-existing valvular disease
• Prosthetic valve
• Congenital heart disease
• IV
aureus, Coagulase-negative ... staphylococci Culture Negative ... ↑ ESR, CRP • EKG ... Differential #Diagnosis #cardiology ... #infectiousdiseases
Microorganisms Responsible for Infective Endocarditis

Native valves:
 - Streptococcus viridans 
 - Enterococci 
 - Other streptococci
epidermidis - Gram-negative ... ) - Culture negative ... Enterococci - Gram-negative ... streptococci - Culture negative ... #Differential #InfectiousDiseases
Table 3. Suggested Empiric Treatment Options for Clinically Suspected Ventilator-Associated Pneumonia in Units Where Empiric Methicillin-Resistant
Antipseudomonal/Gram-Negative ... Appropriate #Management #InfectiousDiseases
Dextrocardia on EKG
 • Limb leads look like LA ←→ RA transposition
 • V1 ←→ V2
Dextrocardia on EKG ... predominantly negative ... #Dextrocardia #EKG ... #ECG #electrocardiogram ... #cardiology #diagnosis
Causes of blood culture negative infective endocarditis

Bartonella spp, Brucella spp, Coxiella burnetii, Chlamydia spp, Tropheryma whipplei,
blood culture negative ... causes #culture #negative ... #Endocarditis #InfectiousDiseases ... #CNIE #BCNIE #cardiology
Typical (Counterclockwise) and Reverse Typical (Clockwise) Atrial Flutter on EKG
Typical (Counterclockwise) Atrial Flutter
 • Inferior leads:
Atrial Flutter on EKG ... up, slow down; "negative ... • V1: Broad & negative ... #ekg #electrocardiogram ... #cardiology #clinical
Legionnaire's Disease - Extrapulmonary organ involvement: CNS: Mental confusion, encephalopathic, headache. Cardiac: Relative bradycardia. GI: Loose
Cardiac: Relative ... Diagnosis #IM #InfectiousDisease
R Wave Progression - normal chest lead ECG shows an rS-type complex in lead V1 with
normal chest lead ECG ... increase in the relative ... #Diagnosis #Cardiology ... #MedStudent #EKG
Causes of Relative Bradycardia - Note the propensity for intracellular organisms.
Infectious: 
Legionella, Psittacosis, Q fever, Typhoid
Causes of Relative ... Drug fever #relative ... differential #diagnosis #infectiousdiseases
Transplant Infections Timeline
Pre-transplant:
 • Common bacteria (endogenous): Staphylococci (skin), Gram-negative bacilli (gut)
 • Viruses: HSV (reactivation)
Engraftment:
Staphylococci (skin), Gram-negative ... Staphylococci (skin), Gram-negative ... diagnosis #causes #infectiousdiseases