Deep Vein Thrombosis: Invasive Treatment & Natriuretic Peptide Tests

Posted on Feb 1, 2025 in Microbiology

Indications for Invasive Treatment of Deep Vein Thrombosis

Indications:
  • Phlegmasia
  • Symptoms of IVC thrombosis
  • Acute iliofemoral DVT
Methods:
  • Insert IV line into a vein
  • Anesthesia is injected
  • A small incision is made
  • Guided X-ray, insert catheter via skin
  • Contrast media injected
  • X-ray is taken to find clot location
  • Clot-dissolving drugs are given
  • Catheter removed, pressure to stop bleeding
  • Dressing is put on
Post-op:
  • Daily examination of calves
  • Anticoagulants
  • Stay hydrated
  • Bed rest
  • Foot elevation

B-type Natriuretic Peptide (BNP) and NT-proBNP: Evaluation and Interpretation of Lab Test Results

BNP is released from the cardiac ventricles in response to volume expansion and wall stress.
  • Diuretic, natriuretic, and hypotensive effects
  • Inhibit RAAS system and renal sympathetic activity
BNPNT-proBNPInterpretation
< 100 pg/mL< 300 pg/mLHF unlikely
100 – 500 pg/mL300 – 450 pg/mL (< 50 yrs) or 300 – 900 pg/mL (> 50 yrs)HF possible
> 500 pg/mL> 450 pg/mL (< 50 yrs) or > 900 pg/mL (> 50 yrs)HF likely
NT-proBNP is the precursor of BNP with longer half-life and higher accuracy.

Most Common Pathogens of Infectious Pericarditis, Their Diagnostic Possibilities

Causes:
  • Virus: Coxsackievirus, Echovirus, Adenovirus, EBV, CMV, Influenza, Rubella, HIV, Hepatitis B
  • Bacteria: Staphylococci, Streptococci, Pneumococci
VirusBacteriaFungiProtozoa
CoxsackievirusStaphylococciAspergillusEntamoeba
EchovirusStaphylococcus aureusCandida spp.Toxoplasma gondii
Influenza (A+B)Haemophilus influenzaeBlastomyces
Hepatitis BSalmonellaCoccidioides
PseudomonasCryptococci
BrucellaHistoplasma
Diagnosis:
  • Dyspnea
  • Fever
  • Dry Cough
  • Sweating
  • Pericardial rub
  • CT scan
  • MRI
  • X-ray (Large Arteries)
  • Electrocardiogram

Diagnostic Criteria of Infective Endocarditis

Major CriteriaMinor Criteria
Typical microorganisms consistent with IE from 2 separate blood cultures
Single positive blood culture for C. burnetii or IgG antibody titer > 1:800
Echo positive
New valvular regurgitation
1. Predisposition: Heart condition, Intravenous drug use
2. Fever > 38°C
3. Vascular phenomena: Arterial emboli, Septic pulmonary infarct, Mycotic aneurysm
4. Immune phenomena: Glomerulonephritis, Osler nodes, Roth spots
5. Microbiological evidence: Positive blood culture, Serological evidence
Diagnosis:
  • 2 Major
  • 1 Major + 3 Minor
  • 5 Minor
Confirm IE