133.2 ð åèç
133.2.0.1 å¿ è â Modified Duke Criteria (èšäœ cluster)
Major (2 å): Blood culture + Echo
Minor (5 å): âPFEVEâ: - Predisposition (cardiac, IVDU) - Fever - Vascular phenomena (Janeway, emboli) - Immunologic (Osler, Roth, GN, RF) - Microbiology (single + or atypical)
(FE-VI-M ä¹æ â å¯èªéž mnemonic)
133.2.0.2 å¿ è â ç¶å ž IE Skin Findings
| Sign | ç¹åŸµ |
|---|---|
| Janeway lesions | Painless macules on palms/soles (vascular) |
| Osler nodes | Painful pulps of fingers/toes (immunologic) |
| Roth spots | Retinal hemorrhages with pale centers (immunologic) |
| Splinter hemorrhages | Subungual linear hemorrhages |
133.2.0.3 å¿ è â Specific Organisms
| Organism | ç¹æ® association |
|---|---|
| S. viridans | Native valve subacute, dental |
| S. gallolyticus (S. bovis) | Colon cancer association â colonoscopy screeningå¿ å |
| S. aureus | Acute, IVDU, healthcare, fulminant; right-sided in IVDU |
| Enterococcus | GU/GI source; elderly; need synergy (amp + gent) |
| HACEK | Slow-growing GN; oral commensal |
| Coxiella burnetii (Q fever) | Sheep, cattle exposure; serology |
| Bartonella | Cat exposure (B. henselae); homeless (B. quintana); culture-negative |
| Candida | IVDU, prosthetic valve, central line; large vegetation; always surgery |