PHRM 211 Lecture Notes - Lecture 31: Coagulase, Staphylococcus, Pulmonary Valve
Document Summary
Definition : microbial infection of the endocardial surface of the heart ( valves most commonly affected) Low income countries : rheumatic heart disease (biggest risk factor), occurs in young adults due to viridans group streptococci (vgs) from oral cavity. Mitral valve prolapse, rheumatic heart disease, prosthetic heart valves, congenital heart disease. Devices (e. g. shunts, stents, pacemakers, defibrillators, tavr) Pathogenesis: pathogens gain access to the bloodstream (transient, adherence to valve surface (injured or inflamed, persistence of bacteria, proliferation, dissemination. Varies, often mitral (most common) or aortic valves (worse prognosis) High bug density 10 9 -10 10 , platelet rich thrombus, inflammatory leukocytes. Low o2 supply, acidic environment, poor antibiotic penetration. Others: aureus (+ coagulase, epidermis (coagulase -ve) Strep : commensals of the oral, gi/gu urogenital tract. Demonstrated by culture or histology in a vegetation or. Blood cultures positive for ie x 2 or. Presence of a vegetation, abscess, or new partial dehiscence of prosthetic valve.
