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Dental Management 2 Infective Endocarditis

Terms in this set (14)

what is the most common underlying condition among patients who have infective endocarditis?
mitral valve prolapse
what are the three most common causative organisms of infective endocarditis?
streptococci (most common, esp Viridans)
staphylococci (Staph aureus)
enterococci
what is the most common causative organism of IE with IV drug abuse or health care contact?
staphylococci
pathophysiology of IE
1. endothelial damage (usually a leaflet)
2. fibrin and platelets adhere to endothelial surface --> nonbacterial thrombotic endocarditis
3. bacteria start to adhere to the mass
4. more fibrin and platelets adhere to the mass --> vegetative mass
5. bacteria metabolic and cellular activity decreases
6. antibiotics decrease in effectiveness
7. bacteremia
classic findings in infective endocarditis
fever, heart murmur, positive blood culture
osler nodes
small, tender, subcutaneous nodules that develop in the pulp of the digits
Janeway lesions
small, erythematous or hemorrhagic, macular nontender lesions on the palms and soles
signs of infective endocarditis seen on the nails and fingers (2)
splinter hemorrhages
clubbing of digits
roth spots
oval retinal hemorrhages with pale centers
abx of choice for IE caused by viridans streptococci
penicillin or ceftriaxone
(add gentamicin for synergistic effect)
if patient can't tolerate penicillin or ceftriaxone, what abx?
vancomycin
abx for IE caused by staph aureus?
nafcillin or oxacillin
do dental procedures cause IE?
probably not!!! it's more likely caused by daily activities like toothbrushing, use of toothpicks, etc. than any dental procedure. the average person sees the dentist less than twice a year. doesn't make sense you'd get it from the dentist!
when are prophylactic antibiotics recommended before a dental procedure to help prevent IE?
American Heart Association recommends abx prophylaxis for high-risk patients (patients with underlying cardiac conditions)

for procedures that involve the manipulation of gingival tissues or the periapical region of the tooth or perforation of the oral mucosa
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