Figure 1. The valve shows inflammatory cells mixed with bacterial colonies (black areas on hematoxylin-eosin stain).
| Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc |
| Journal website http://www.journalmc.org |
Case Report
Volume 6, Number 2, February 2015, pages 51-54
Aortic Insufficiency Secondary to Enterococcus faecalis Endocarditis in an HIV-Positive Patient
Figure
Tables
| If these criteria thresholds are not met or either an alternative explanation for illness is identified or the patient has defervesce within 4 days, endocarditis is highly unlikely. |
| Major criteria |
| Two positive blood cultures for a typical microorganism of infective endocarditis |
| Positive echocardiography (vegetation, myocardial abscess or new partial dehiscence of a prosthetic valve) |
| New regurgitant murmur |
| Minor criteria |
| Presence of a predisposing condition (fever >38 °C) |
| Embolic disease |
| Immunological phenomena |
| Osler nodes |
| Roth spots |
| Glomerulonephritis |
| Rheumatoid factor |
| Positive blood cultures not meeting the major criteria or serologic evidence of active infection with an organism that causes endocarditis |
| A definite diagnosis of endocarditis (80% accuracy) is made with: |
| 2 major criteria |
| 1 major criterion and 3 minor criteria |
| 5 minor criteria |
| Possible endocarditis: |
| 1 major and 1 minor criterion |
| 3 minor criteria |
| The recommended duration of combined therapy should be 4 - 6 weeks. | ||
| Penicillin | + | Streptomycin or gentamycin (aminoglycoside of choice due to less resistance) |
| Ampicillin 2 g IV every 4 h | + | Gentamycin 1 mg/kg IV every 8 h |
| Penicillin-G 3 - 4 × 106 units every 4 h | + | Gentamycin 1 mg/kg IV every 8 h |
| If patient is allergic to penicillin: vancomycin 15 mg/kg IV every 12 h | + | Gentamycin 1 mg/kg IV every 8 h |