it is an infectious disease in which the endocardium of the cardiac muscle is being affected.

1. CASE PESESNTATION
ON
INFECTIVE
ENDOCARDITISBY
B.Hari krishna
III/VI PharmD
Y16PHD1102

2. A patient was admitted to hospital with c/o fever and
experiencing fever from last 2 weeks.
Vitals:
Temp :38.90C
PR :90 bpm
RR :22 times/ hour
BP : 152/92 mm of Hg

3. • Family history : father has hypertension nad died due to
myocardial infection
• Surgical history : aortic stenoso,S/p AVR with
bioprosthetic valve (6 months)
• CVS : S1S2
+
• CNS : -
• RS : -
• GU/GI : -
• EENT : -
• DERM : -

4. Investigation Observed value Standard value
Sr.creatinine(mg/
dl)
0.8
Na + (meq/L) 136
K + (meq/L) 4.1
Cl – (meq/L) 102
PPBS (mg/dL) 98
ECG : Non specific T wave changes
Chest Xray : normal heart size
2D- echo cardiogram : vegetations not visualized on heart valves
Transesophageal echocardiogram : 6mm vegetation noted on aortic valv
mild aortic regurgitution
Blood culture test : staphyllococcal infection was observ

5. Assesment:
• Diagnosis : infective endocarditis
(due to staphylococcus aureus
bacterial infection)

6. Sn
o
Drugs Dose ROA Frequenc
y
Day 1 Day 2
1 Vancomyci
n
30mg Iv TID + -
2 Methicillin+
ceftriaxone
2 mg Iv QID _ +
3 Metformin 1 gm Oral BD + +
4 Amlodipine 10mg Oral OD + +

7. • Goals of treatment:
to treat infection
• Treatment plan :
1. Nafacillin-2g IV QID for 4 weeks + Gentamycin -1mg/kg
IM TID for 3-5 days.
(or)
2. Cefazolin- 2g IV QID for 4 weeks + Gentamycin -
1mg/kg IM TID for 3-5 days.
3. Vancomycin – 15mg/ kg IV BID for 4-6 weeks

8. • Infective endocarditis: it is a bacterial infection occurs in
heart chambers and walls due to growth microbes .
• It cannot be characterized by physical appearance
• But diagnosed by blood culture test & Transesophageal
echocardiogram
• Prevention :
• Regular check of tooth and gums
• Decreased exposure to unhygenic areas
• Regular brushing and flossing of teeth

9. • Very minor :
• Metformin with Amlodipine
• amlodipine decreases effects of
metformin by pharmacodynamic
antagonism

10. • Amlodipine was replaced with lisinopril(10 mg oral ) to
lower the effects of amlodipine.
• To give effective treatment vancomycin can be relaced
with the combination ceftriaxone + gentamycin . By
considering the economical facctor vancomycin is
choosen