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

Janeway_lesion_ie_edt2

 

– Osler nodes- painful, purple, fingertips, tips of toes, immune complex deposition

Oslers_nodes_in_ie

 

– Splinter Hemorrhage- thin red/brown, thin, fingernails, vasculitis

Splinter_hemorrhages_in_ie

 

 

– 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