A site for medical students - Practical,Theory,Osce Notes

Showing posts with label infective endocarditis. Show all posts
Showing posts with label infective endocarditis. Show all posts

Markers of infective endocarditis

Findings in Hands
  • Clubbing
  • Osler's nodes are reddish purple tender nodule in distal pad of finger and toe
  • Janeway lesions  are coalesced non-tender hemorrhagic lesion of palm and sole.
  • Splinter haemorrhages  are linear subungual hemorrhage - distal third of nail.
Findings in Eyes
  • Pallor and Roth spots

Clinical manifestations of Infective Endocarditis

Fever is the most common manifestation of Infective Endocarditis (IE).
Heart murmurs are seen in 80 - 85% of cases
Enlargement of spleen is seen in 15 - 50% of cases.

Peripheral manifestations of IE are 
1. Petechiae is the most common peripheral sign
Palpebral conjunctiva, the buccal and palatal mucosa, and the extremities are the common sites of Petechiae

2. Splinter Hemorrhages
It is nonspecific and nonblanching 
Appear as linear reddish-brown lesions found under the nail bed
Usually do not extend the entire length of the nail

3. Osler’s Nodes
More specific for IE
Painful and erythematous nodules
Located on pulp of fingers and toes
More common in subacute IE
4 P’s related to oslers nodes are
Pulp of the fingers/toes

4. Janeway Lesions
More specific
Erythematous, blanching macules 
Located on palms and soles

Myalgia, arthralgia, back pain can be present in IE patients

Systemic embolisation manifest as neurological and renal involvement 
Neurological manifestations are embolic stroke (most common) and mycotic aneurysm.
Renal insufficiency, immune-complex mediated glomerulonephritis  embolic renal infarct can occur in IE.