Infective endocarditis

• Facts:
  Infection of the endocardium
  MC affects heart valves
• History / PE:
  Fever/FUO
  Weight loss
  Fatigue
  New onset heart murmur
• Diagnosis:
  Duke criteria
  CBC with leukocytosis and left shift
  Increase ESR and CRP
• Treatment:
  Early empiric ABx ( vancomycin or nafcillin+gentamicin)
• Pneumonic:
  JR=NO FAME (presentation of endocarditis)
  
  J aneway lesions (painless)
  R oth's spots
  
  N ail-bed(splinter) hemorrhages
  O sler's nodes
  
  F ever
  A nemia
  M urmur
  E mboli
• Notes:
  Prophylactic ABx to pts with previous endocarditis history or prosthetic valves (2 grams of amoxicillin)
  
  Streptococcus bovis endocarditis is associated with colorectal cancer (colonoscopy screening required)
• See Also:
  Acute endocarditis (high grade fever, MCC is S. aureus)
  Sub- acute endocarditis (low grade fever, MCC is Strep viridans)
  Marantic endocarditis
  Culture Negative Endocarditis
  SLE Endocarditis