Monday, April 30, 2007

Stigmata of infective endocarditis

  • Fever (often spiking)
  • Continuous presence of micro-organisms in the bloodstream in serial collection of blood cultures
  • Vegetations on valves on echocardiography, which sometimes can cause a new or changing heart murmur, particularly murmurs suggestive of valvular regurgitation
  • Vascular phenomena:
  • Septic emboli - mitral regurg -> LA dilatation -> ectopic foci -> stasis in LA -> formation of thrombi -> circulatory problems such as stroke or gangrene of fingers
  • Janeway lesions (painless hemorrhagic cutaneous lesions on the palms and soles)
  • hemorrhage: intracranial hemorrhage, conjunctival hemorrhage, splinter hemorrhages
  • Immunologic phenomena: Glomerulonephritis, Osler's nodes (painful subcutaneous lesions in the distal fingers), Roth's spots on the retina, positive serum rheumatoid factor




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