Dukes Criteria for IE

 a bit about Dukes Criteria .
Major :
Little scarry bug
•  viridans streptococci, Streptococcus bovis, or HACEK group , or
•  community-acquired Staphylococcus aureus or enterococci, in the absence of a primary focus

 

on the Heart  what is seen ?

• perivascular abcess
• prosthethic valve
• valvular regurgitation.. newly formed...

Minor criteria ..

Clinical SiGN 

Osler Nodules

 Flat, painless, erythematous lesions 

-roth spot
-splinter H/r






IE, risk factor for old age patient, drug abuse-narcotic IV,  went to OT( tooth extraction, tonsilectomy, obs n gyne procedures and etc), Prosthetic Valve Replacement, Cardiac Transplant....

IE onset with Fever followed with Chille.
Aneamic Syndrome : pallor, asthernic, fatigue and weakness. Why? huporegeneration anemia ( blood analysis may show leococytopenia).. due to Bone marrow suppression .. which later lead to Spleenomegaly.. compensatory .

IE morphology in echocardiogram commonly is vegetation and perforation of valve.. most common is aourtic valve( diff diagnose with RF=>Mitral Valve)

                                                              vegetation of aoutic valve lealet 

main target organ of damage for  IE is heart .. infective endocardial surface...

enuf for today... sambung esok ... heheheheh

Chilaiditi syndrome

Chilaiditi Syndrome is transposition of a loop of large intestine (usually transverse colon) in between the diaphragm and the liver.
also known as 

•  interpositio hepatodiaphragmatica,
•  subphrenic displacement of the colon,
•  subphrenic interposition syndrome and
•  pseudopneumoperitoneum.

triad for CS is, abdominal pain, volvulus and shortness of breath..

on X-ray, classically u will find , gas in the right hemidiagphragma always misdiagnose with pneumoperitoneum...

 A small crescent of air can be seen under the right part of the diaphragm

gas between liver and diaphragmrugal 

rugal folds within the gas suggesting that it is within bowel and not free

COD:a long and mobile colon (dolichocolon), chronic lung disease such as emphysema, or liver problems such as cirrhosis and ascites.