Figure 1 Quiz of the Week
A 55-year-old female presents with a low-grade fever, a new heart murmur, and Janeway lesions one week following a dental cleaning, and a preliminary diagnosis of infective endocarditis is made. Prophylactic antibiotics are administered prior to dental cleanings to prevent endocarditis in patients considered to be high-risk.
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Image credit: @michaeldean.
Answer: Prosthetic aortic valve replacement
Historically, antibiotic prophylaxis was thought to be very effective in preventing endocarditis. More recently, it has become understood that transient bacteremia can occur from everyday tasks such as brushing or flossing one’s teeth. Limiting antibiotic prescriptions to patients with structural damage to the valve’s surface protects those at risk of life-threatening complications while limiting the potential for antibiotic resistance.
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