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Medicine General 5d41ef01

All of the following statements are TRUE about infectious endocarditis EXCEPT

A
Cardiac valve leaflets are susceptible to infection because of their limited blood supply
B
Fatality rates for right-sided disease are greater than those for left-sided disease
C
Streptococcus viridans is the most common organism implicated in left-sided disease
D
More than three-fouhs of cases of right-sided endocarditis are caused by Staphyloccus aureus
High-Yield Explanation
Fatality rates for left-sided disease are greater than those for right-sided disease because of the increased incidence of cardiac failure and neurologic complications. Streptococcus viridans is the most common organism implicated in left-sided endocarditis, with Staphylococcus aureus increasing in incidence. Enterococcal and fungal infections are also seen. Right-sided endocarditis is caused by S. aureus in more than 75 percent of cases, followed by S. viridans and gram-negative rods. Blood cultures should be drawn from three different venous sites and sent for aerobic, anaerobic, and fungal cultures. Antifungal agents should be considered in patients with HIV or other immunocompromised states or in patients with indwelling catheters. Murmurs are heard in only 35 to 50 percent of patients with right-sided disease but in up to 80 percent of patients with left-sided disease.

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