56 results
Endocarditis checklist
Initial evaluation
 • Peripheral blood cultures (three sets at three different sites)
 • Additional culture
Endocarditis checklist ... • Persistent fever ... • Aggressive management ... Internet Book of Critical ... criticalcare #diagnosis #management
Duke's Criteria for Infective Endocarditis
Definite IE - Pathologic Criteria:
 • Pathologic lesions - vegetation or intracardiac
for Infective Endocarditis ... demonstrating active endocarditis ... demonstrated by culture ... Predisposition • Fever ... criteria #Infective #Endocarditis
Endocarditis Summary

Who?
Infectious:
• Pre-existing valvular disease
• Prosthetic valve
• Congenital heart disease
• IV substance use
• IV catheter
• Recent
Hypercoagulable (APLAS) Microbiology ... : Blood cultures ... night sweats, fever ... Persistent bacteremia/fevers ... #diagnosis #management
Janeway Lesions in Endocarditis seen on Physical Exam 

Dr Supradip Ghosh
@dr_supradip

36 year old male with history
left hemiplegia, fevers ... Blood cultures growing ... with persistent fever ... - Clinical examination ... #PhysicalExam #clinical
Blood Culture Collection Algorithm - Adult Patients with Suspected Systemic Infection 

Pawlowicz et al evidenced based
Blood Culture Collection ... to obtain blood cultures ... infections, whose clinical ... tract infection, endocarditis ... #Management #BloodCultures
Differentiating NBTE from Infective Endocarditis
No pathognomonic signs/symptoms or echo features that are specific to NBTE, and
high index of clinical ... Hypercoagulable states • Clinical ... features: Fever ... indwelling catheters • Clinical ... features: Fever
Streptocccus Pneumoniae
Microbiology: Gram Positive, Alpha-hemolytic, Catalase Negative
Epidemiology - 10% adult carriers:
 • Most common cause of:
Streptocccus Pneumoniae Microbiology ... peritonitis, and endocarditis ... sinus • Sputum culture ... Pneumoniae #strep #microbiology ... #diagnosis #management
Spinal Epidural Abscess - Illness Script
Epidemiology:
 - Patients at risk for bacteremia: IVDU, dental abscess, HD
, HD catheter, endocarditis ... Alcoholism, DM, HIV Microbiology ... most common (63%) Clinical ... but rare triad: Fever ... source: blood cultures
Leptospirosis
Pathogen: Leptospira (interrogans, kirschneri, noguchii)
Risk Factors:
 • Occupational exposure - Farmers, ranchers, trappers, veterinarians
 • Recreational
Leptospirosis Pathogen ... Epidemiologic exposure + clinical ... TheIDtrivia #Leptospirosis ... #Leptospira #microbiology ... diagnosis #treatment #management
Fusarium on Culture and Microscopy
Collecting a sample for culture from the eye is never fun, but
Fusarium on Culture ... from the eye is never ... positive fungal culture ... #Microscopy #clinical ... #microbiology