FTYKTKA: Endocarditis · ENDOCARDITIS. BY OSI.ER, M.D.. THE type Of endocarditis characterised by a...
Transcript of FTYKTKA: Endocarditis · ENDOCARDITIS. BY OSI.ER, M.D.. THE type Of endocarditis characterised by a...
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FTYKTKA: Endocarditis
Dr. David Carr February 24th 2015
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I have no conflict of interest
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The guy who does the cultures
• 70 y.o female diabetic unwell for 2 weeks • Blood cultures grew strep bovis • You call the pt: “feels ok” What next? A) Never heard of it must be contaminant B) Reassurance C) Repeat cultures send her home for the w/e D) Wikipedia it
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The 5 Commandments of IE
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1. Examine your febrile pts
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Look for the classics
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Look at their patients teeth
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Physical exam new millenium
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2. Know your high risk patients
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IVDU + Fever = IE (15%)
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Valve + Fever OR unwell= IE
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3. Know what to do with BC’s
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Probably a contaminant eh?
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Coag neg staph + valve = IE
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CNS & N valve not always a contaminant: Look for the SLUG
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4. Get nervous when the bacteria does not fit the crime
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5. Empiric Rx only if urgent
Sanford Guide 2013
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No ER SBE prophylaxis needed
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Take Home Points
• Respect fever in all comers • Be afraid of valves and IVDU • Know what to do with abnormal cultures • Be afraid of the wrong bugs in the wrong sites • You almost never need to treat or pre treat
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