Confirmation, investigations

and management of IE
Confirmation- Duke criteria
Investigations
• Blood cultures
• Echocardiography- detects vegetations, abscess formation
• ECG- any rhythm abnormalities
• CXR- may show evidence of HF
• Blood test- elevated WCC, ESR and CRP
Management
• Empirical therapy
• Antibiotic therapy for 4-6 weeks
• Penicillin, gentamicin
• Penicillin allergy, use vancomycin
• Those with prosthetic valve need longer duration of treatment
• Severe destruction of valve may require surgical repair or
replacement