Infective Endocarditis
Protocols
Clinical Features:
- 1)Malaise
- 2)Clubbing
- 3)Cardiac
- -murmur
- -HF
- 4)Arthralgia
- 5)Pyrexia
- 6)Skin lesion
- -Osler;s node
- -Splinter haemorrhages
- -janway lesions
- -Petechiae
- 7)Eye
- -Roth spot
- -Conjunctival splinter haemorrhage
- 8)neurological features
- 9)Haematuria
investigation:
- 1)blood culture
- 2)Echo-vagetations
- 3)ESR-rasied
- 4)CRP-rasied
- 5)CBC with PBF-normocytic normochromic anaemia
- 6)Urine R/E-microscopic haematuria
- 7)ECG-AV block
- 8)CXR-cardiomegaly
Rx:
Before culture sensitivity test
- inj.Benzyl Penicillin (Pen-G) (10lac/u) 2-3 million/u every 4 hours
plus(+)
- Oxacillin/nafcillin 1.5 gram every 4 hours
plus
- inj.[post id="416" title="Gentamicin"](Gentin)( 80mg/2ml) 1mg/kg –tds
If Benzyl Penicillin (pen-G) sensitivity-
- inj.covan([post id="437" title="Vancomycin"]) 15mg/kg -BD
Accourding to sensitivity:
A) Streptococcus viridans/other streaptococcus:
- inj.Benzyl Penicillin (pen-G)(10lac/u) 2-3 million/unit I/v 4 hoursly 4-6 wks
and
- inj.[post id="416" title="Gentamicin"](gentin)(80mg/2ml) 1mg/kg 8 hourly 2 wks
OR
- inj.[post id="398" title="Ceftriaxone"](Ceftron) (2gm) I/v daily 4 wks
OR
- inj.covan ([post id="437" title="Vancomycin"]) 15 m/kg I/v -Bd 4-6 wks
B)Enterococci
- inj.[post id="412" title="Ampicillin"](ampexin)(500mg) I/v 4hourly
plus
- inj.post id="416" title="Gentamicin"](Gentin)(80mg/2ml) 1mg/kg I/v-bd 2 wks
OR
- inj.[post id="437" title="Vancomycin"](covan) 15mg/kg-BD 6 wks