5. infeksi jantung10

7/28/2019 5. infeksi jantung10

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Microbial Infection of the CVS

Dr.D.Y.Riyanto,MSc.Dept.of Microbiology

Sriwijaya Univ.Sch.of Medicine/

RSUP Dr.M.HoesinPalembang


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Heart and blood vessels always sterile

Isolation of bacteria or fungi: infection!

Bacteria:bacteriemia

Fungi:fungaemiaVirus:viremia

Microbe:microbemia


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Cardiovascular Infection

1.Pericarditis2.Myocarditis

3.Endocarditis

4.Pancarditis

5.Septic shock (SIRS)


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Etiologic agents

Gram (+) coccus

Staphylococcus aureusS.epidermidis

Streptococcus viridans

S.pneumoniae

S.pyogenesEnterococcus

Gram(-) coccus

Neisseria meningitidisN.gonorrhoeae


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Gram(-) bacil : Haemophylus influenzae

& many others (E.coli,K.pneumoniae)

Chlamydia trachomatis

Chl.psittaci

Rickettsia

Fungi : Candida albicans

Virus : HIV,DHF

nonInfection: exotoxin C.diphtheriae

Rheumatic heart disease


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S.pneumoniae


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E.coli


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Streptococcus viridans


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Enterococcus


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Chlamydia:inclusion bodies


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Diphtheria :child


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Treponema pallidum


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Source of Infections

Teeth:dental procedure,poor dental hygienneLung infection

Throat

BacteriaemiaIVFD & IV drug abuser

Catheterization

Others (surgery)


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Previous condition / predisposing factors

1.Underlying heart diseaseCongenital valve deformities

Ventricular septal defect

Tetralogy of FallotTransposition of Great Vessels

Patent ductus arteriosus Botalli

Others (cardiomyopathy)

2.Rheumatic fever (post streptococcal)


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Bacterial Endocarditis(acute & subacute bacterial endocarditis)

Bacterial infection of the endocardium

Symptoms of systemic infection,embolic pneumonia,

and endocardial vegetations.

The course of infection maybe acute or subacute,

depending on the virulence of infecting bacteria.


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Symptom and signs

-Insidious onset of SBE-May mimic many systemic diseases without

early signs of cardiac involvement

-Fever,remittent,irregular or sustained,seldom > 39 C

-malaise,fatigue,weight loss,skin petechiae

-embolic infarction of vital organs

-valve dysfunctioncongestive heart failure


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Severe Inflammatory Response Syndrome

(septic shock)

Etiology:Gram (-) enteric bacilli

Gr(+)cocci,C.albicans.

Pathogenesis:release of inflammatory mediators

local circulatory failuremulti organ failure

Manifestation:hypotension,hypoxia,respiratory failure,

lactic acidosis,renal failure,DIC & bleeding.


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Laboratory Diagnosis

Specimens: blood,taken during fever,3-4x/day

Culture in Bactec machine (otomatic blood culture)

BHI and blood agar/other agar media.

(MacConkey,MTM,or anaerobic media)antimicrobial susceptibility testing

Serology

PCR


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Pathogenesis

Microbelymphatic systembloodheartvalvesbacterial attachmentcolonization

infection:- covered by fibrin & platelets

- protect from phagocytes &complement

- embolism if dislodge


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Treatment

1.Antimicrobial / antibiotics2.Antifungal

3.Antiviral

4.Supportive therapy


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Thank you

Thank You

5. infeksi jantung10

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