Infective Endocarditis

Cardiovascular · ~11% of blueprint

Pathophysiology: Microbial infection of endocardium/valves → vegetations. S. aureus (acute; IVDU → tricuspid), Strep viridans (subacute, native valve), Enterococcus.
Signs & Symptoms: Fever + new murmur. Janeway lesions, Osler nodes, Roth spots, splinter hemorrhages, splenomegaly, embolic phenomena.
Gold Standard Diagnosis: Modified Duke criteria: blood cultures (≥3 sets) + echocardiography (TEE most sensitive for vegetations).
First-line Treatment: Empiric IV antibiotics (e.g., vancomycin ± gentamicin), then tailor to cultures. Surgery for HF, abscess, or large/embolizing vegetations.

High-Yield Pearl

Draw blood cultures BEFORE antibiotics. IVDU → right-sided (tricuspid) disease with septic pulmonary emboli.

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