Endocarditis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Common signs on physical examination of endocarditis include fever, presence of a new or changing heart murmur, rigors, Osler's nodes, Janeway lesions and evidence of embolization. Aortic insufficiency with a wide pulse pressure, mitral regurgitation or tricuspid regurgitation may be present depending upon the valve that is infected.

Physical Examination

Appearance of the Patient

Vital Signs

Skin

Petechiae Minor Petechia.jpg
Splinter hemorrhages Splinter hemorrhage.jpg
Osler's nodes Osler's Lesions (Endocarditis).jpg
Janeway lesions Skin janeway.jpg

Oral Cavity

Examine the oral cavity:

HEENT


Roth's spots (white centered hemorrhage)







Neck

  • Neck examination of patients with endocarditis is usually normal.

Lungs

Heart

Abdomen

Back

  • Back examination of patients with endocarditis is usually normal

Genitourinary

  • Genitourinary examination of patients with endocarditis is usually normal.

Neurologic

Extremities


References

  1. Baddour, LM.; Wilson, WR.; Bayer, AS.; Fowler, VG.; Bolger, AF.; Levison, ME.; Ferrieri, P.; Gerber, MA.; Tani, LY. (2005). "Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America". Circulation. 111 (23): e394–434. doi:10.1161/CIRCULATIONAHA.105.165564. PMID 15956145. Unknown parameter |month= ignored (help)
  2. Lockhart PB, Brennan MT, Thornhill M, Michalowicz BS, Noll J, Bahrani-Mougeot FK; et al. (2009). "Poor oral hygiene as a risk factor for infective endocarditis-related bacteremia". J Am Dent Assoc. 140 (10): 1238–44. PMC 2770162. PMID 19797553.
  3. John MD, Hibberd PL, Karchmer AW, Sleeper LA, Calderwood SB (1998). "Staphylococcus aureus prosthetic valve endocarditis: optimal management and risk factors for death". Clin Infect Dis. 26 (6): 1302–9. doi:10.1086/516378. PMID 9636852.
  4. John MD, Hibberd PL, Karchmer AW, Sleeper LA, Calderwood SB (1998). "Staphylococcus aureus prosthetic valve endocarditis: optimal management and risk factors for death". Clin Infect Dis. 26 (6): 1302–9. doi:10.1086/516378. PMID 9636852.


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