Clinical features of

Infective Endocarditis
1) Farah Nurhalida
2) Nurhanis Syahira
3) Kartigan
4) Siti Sarah
Fever
Roth’s spot
Osler nodes
Murmur

Janeway lesion
Anemia
Nail hemorrhage
Emboli
Constitutional symptoms

 Fever with chills and rigors

 Malaise
 Anorexia
 Weight loss
 Night sweats
 Headache
 Myalgia
General examination
 Febrile
 Lethargic
 Finger Clubbing
General examination
Common complaints of drug abusers = Right-sided endocarditis
 Shortness of breath
 Cough with blood sputum
 Pleuritic chest pain
 Murmur of tricuspid regurgitation is typical
 Skin lesions
Janeway lesions Osler nodes
Painless, small erythematous or haemorrhagic Painful erythematous swellings, small and
macular or nodular lesions palpable

 Both can be seen on finger pads, palms and soles of feet

 Osler nodes are more commonly present
 Skin lesions
Splinter hemorrhage Petechiae
Linear bleeding under a fingernail or toenail Numerous tiny purple or red spots appearing on skin
 Eyes
Roth’s spot Subconjunctival hemorrhage
Retinal hemorrhages with small, clear centers
 Cardiovascular
 Tachycardia
 Murmurs (depends on which valve infected)
 Symptoms of Congestive Cardiac Failure
 Neurological

Cerebral emboli  Stroke Mycotic aneurysm

Localized, irreversible arterial dilation due to
  destruction of vessel wall by infection
 Others
Splenomegaly
Enlargement of spleen causing left
upper quadrant pain Systemic embolism with
abscess formation

Glomerulonephritis
 Hematuria
 Mild to moderate proteinuria
 Odema
 Hypertension
References
 Kumar P, Clark M. (2017). Clinical Medicine, 9th edition. Elsevier Ltd.
 Douglas G, Nicol F, Robertson C. Macleod’s Clinical Examination. 13 ed, London:
Churchill Livingstone Elsevier; 2013
 Longmore J, Wallin E, Baldwin A, Wilkinson I. Oxford Handbook of Clinical
Medicine. 9th ed, Oxford: Oxford University Press; 2014