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Non-infective endocarditis Characteristics and Pathophysiology

By Dr. Sara Dong @swinndong via #IDFellowCase

#ID  #Infectious Diseases  #Infections
#Differential
Non-infective endocarditis ... IDFellowCase #ID ... #Infectious Diseases ... #Infections #Differential ... #Ddx #Diagnosis
Fever in Returning Travelers from Tropical Regions - Frequent Differential Diagnoses
Medical History:
 • Skin exposure to
Regions - Frequent Differential ... infective endocarditis ... , acute HIV infection ... melioidosis, typhoid, pulmonary ... , Lassa fever, acute
Non-Resolving Pneumonias: Etiologies
Unusual Infections:
 - Immunocompromised patients (e.g.: Mycobacterium, Aspergillosis, Nocardia)
 - Endemic Fungi (e.g.: Histoplasmosis,
Etiologies Unusual Infections ... yersinia/rats, Q fever ... pseudomallei, hanta virus ... Eosinophilic PNA (acute ... #differential
Bradycardia - Differential Diagnosis Framework

BRADI Mnemonic
 • BRASH/Hyperkalemia
 • Reduced oxygen/Glucose/Temp
 • ACS
 • Drugs
 •
Bradycardia - Differential ... Drugs • ICP / Infections ... Hyperkalemia Pulmonary ... • Aortic Valve Endocarditis ... Chagas disease • Acute
Causes of Knee Effusions - Differential Diagnosis Framework

Knee Effusion Red Flags:
1. Fever/Chills/Joint pain/Night sweats/Weight loss
	- DDX:
		-
Knee Effusions - Differential ... Fever/Chills/Joint ... Weight loss - DDX ... Reactive Syndrome - Acute ... rheumatic fever
Approach to Joint Pain - Arthritis Differential Diagnosis Framework

Inflammatory Versus Noninflammatory Pain
 • Is it inflammatory
Pain - Arthritis Differential ... • Rheumatic fever ... • Bacterial endocarditis ... streptococci (rheumatic fever ... #Joint #pain #Differential
Endocarditis Summary

Who?
Infectious:
• Pre-existing valvular disease
• Prosthetic valve
• Congenital heart disease
• IV substance use
• IV catheter
• Recent
Culture (+): Acute ... night sweats, fever ... Cerebral > Splenic, pulmonary ... Marantic (NTBE) Differential ... Persistent bacteremia/fevers
Mycoses

HISTOPLASMOSIS
• Inhalation of conidia → Yeast → travel to lymph nodes → spread in body
• Bird
respiratory symptoms • Fever ... nonspecific • DX ... , fever, chills, ... Aspergillosis Pathophysiology ... arthritis, and endocarditis
Differential Diagnosis of Acute Arthritis

Crystal-induced arthritis: Calcium oxalate, gout, cholesterol, pseudogout, hydroxyapatite crystals

Infectious arthritis: Bacteria, fungi,
Differential Diagnosis ... of Acute Arthritis ... Mediterranean fever ... : Bacterial endocarditis ... immunodeficiency virus
Differentiation Syndrome in APML
Epidemiology:
 • Incidence: common in APL (2-48% depending on the study)
 • Triggers:
ATRA treatment Pathophysiology ... : • Common: fever ... Imaging: CXR- pulmonary ... initiation • Differential ... Diagnosis: Infection