Endocarditis Pearls
H&P
– Flu like symptoms + murmur
– Janeway lesions – painless, red macule/patch, palms/soles, culture bacteria from the lesion, embolic manifestation of endocarditis
– Osler nodes- painful, purple, fingertips, tips of toes, immune complex deposition
– Splinter Hemorrhage- thin red/brown, thin, fingernails, vasculitis
– Roth spots- retinal hemorrhage
Risk factors
– Drug abuse
– Prosthetic devices, valve
Diagnosis
– Duke Criteria
– Blood cultures
– TEE
Treatment
– Antibiotics- staph/strep: Vancomycin 15-20 mg/kg q8-12 hrs, max 2 g per dose, up to 6 weeks
Reference: Uptodate
