Endocarditis
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Endocarditis| Ahmed Al-Kaisy |
Posted: January 09, 2008 12:10 pm
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Taking History...  Group: Graduated Doctors Posts: 32 Member No.: 1373 Joined: December 28, 2007  |
a 34 years old man with a history of a bicuspid AV is diagnosed with endocarditis. despite 2 weeks of appropriate antibiotic thrapy, he has persistent fevers and bacteremia. a diagnostic study is performed and a paravalvular abscess discovered. what's the next step in this patient's managment?
1- continue current antibiotic therapy. 2- change nafcillin to vancomycin. 3- change nafcillin to ceftriaxone. 4- add gentamycin 5- refer to surgery. enjoy... |
 
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| Dr.Leo1984 |
Posted: January 09, 2008 12:26 pm
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Auscultating... Group: Graduated Doctors Posts: 839 Member No.: 68 Joined: September 08, 2005 |
4- add Gentamycin to cover a boarder spectrum of the m.o. that causing the abscess...
BUT I AM NOT SURE |
 
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| ali al-kafaji |
Posted: January 09, 2008 07:49 pm
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Diagnosing... Group: Graduated Doctors Posts: 1576 Member No.: 22 Joined: August 14, 2005 |
surgery ra2sen
ali |
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| The Knight |
 Posted: January 10, 2008 03:49 pm
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Auscultating... Group: Graduated Doctors Posts: 620 Member No.: 1119 Joined: July 13, 2007 |
I concur with Ali,
Surgery is manditary... |
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| bloodstone |
Posted: January 10, 2008 08:19 pm
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Diagnosing... Group: Graduated Doctors Posts: 1597 Member No.: 99 Joined: September 26, 2005 |
I think it's
5-refer to surgery |
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| Ahmed Al-Kaisy |
Posted: January 10, 2008 10:28 pm
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Taking History... Group: Graduated Doctors Posts: 32 Member No.: 1373 Joined: December 28, 2007 |
that's right dear all, persistent fevers and bactermia despite 2 weeks on antibiotic therapy are indications for valve replacement surgery. other indications include progressive valvular dysfunction, developement of paravalvular abscess, and recurrnt embolic events. antibiotics alone are inadequate to treat these complications....
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