Atlas of CardioVascular Diseases

[angelic_doc]

[dr.lucy]

الله يديك العافية مره مرتب انا لخصت rheumaticبس اكتشفت انو ناقصتوا اشيا لمن شفت حقك شكررا يا عسل ما شا اله شغالة تسوي في atlasمن سيستم لسيستم الله يوفقك شكلك بعدين حتعملي انقالب في المنتدى ووتغير اسمه اليanagelic atlas in all systemهههههههههها

[angelic_doc]

اقتباس المشاركة الأصلية كتبت بواسطة dr.lucy الله يديك العافية مره مرتب انا لخصت rheumaticبس اكتشفت انو ناقصتوا اشيا لمن شفت حقك شكررا يا عسل ما شا اله شغالة تسوي في atlasمن سيستم لسيستم الله يوفقك شكلك بعدين حتعملي انقالب في المنتدى ووتغير اسمه اليanagelic atlas in all systemهههههههههها

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[tigarshark2006]

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[Dr.active]

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[angelic_doc]

اقتباس المشاركة الأصلية كتبت بواسطة tigarshark2006 يعطيك العافية .. مفيد جدا ..

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و إياكِ

[angelic_doc]

Infective EndoCarditis

Bacterial endocarditis

The clinical picture in subacute bacterial endocarditis (SBE) is primarily due to immune complex disease causing a small-vessel leukocytoclastic vasculitis (Figs 11.24 and 11.25). This is accompanied by splinter hemorrhages, retinal or conjunctival hemorrhages or edema, and lesions on the hands and fingers (Osler’s nodes (Fig. 11.26), Janeway lesions). The presence of bacteria has been documented in the latter lesions, suggesting that at least some of the features of SBE are due to infective emboli.

Fig. 11.24 Subacute bacterial endocarditis in a patient with a prosthetic heart valve. Small vasculitic lesions of this type are common with this type of immune complex disease, and may be quite subtle. Histologically the features are of a non-specific, small-vessel leukocytoclastic vasculitis.



Fig. 11.25 Subacute bacterial endocarditis in the same patient as shown in Fig. 11.24. Conjunctival lesions, as shown here, and retinal vasculitis are uncommon in HSP or drug-related small-vessel vasculitis, and support a presumed diagnosis of SBE. Examination of fundi is diagnostically important in this disorder.



Fig. 11.26 Subacute bacterial endocarditis, demonstrating an Osler’s node of the finger pulp. These lesions may be embolic, as they have recently been demonstrated to contain bacteria.

[angelic_doc]

Embolic vasculitis

Etiology and pathogenesis

Embolic vasculitis may have several causes including:
• bacterial endocarditis (see above) and infective emboli (Fig. 11.32);
• cholesterol emboli; (see Fig. 12.37)
• cardiac myxoma (may be associated with cutaneous myxomas, blue nevi, spotty pigmentation, endocrine disease – Carney complex or LAMB syndrome);
• fat emboli.

Clinical

The features vary to some extent, depending on the cause, but include livedo, infarcts, purpuric lesions, ulcers, and blisters.

Fig. 11.32 Infective emboli causing fingertip pustules. These should be cleaned and pierced in order to obtain bacteriology cultures of the pus content.

[angelic_doc]

Endocarditis occurs when germs enter your bloodstream, travel to your heart, and lodge on abnormal heart valves or damaged heart tissue. Abnormal growths (vegetations) that contain collections of bacteria may form in your heart at the site of the infection

[asphora]

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