Endocarditis physical examination: Difference between revisions

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==Skin==
==Skin==
*[[Petechiae]] are present in 10% to 40% of patients
*[[Petechiae]] are present in 10% to 40% of patients
*[[Splinter haemorrhage]] are present in 5% to 15% of patients
* Splinter hemorrhages are present in 5% to 15% of patients
*[[Osler's nodes]] which are tender subcutaneous nodules in pulp of digits are present in 7% to 10% of patients
*[[Osler's nodes]] which are tender subcutaneous nodules in pulp of digits are present in 7% to 10% of patients
*[[Janeway lesion]]s which are [[erythema]]tous, nontender lesions on palm or sole are present in 6% to 10% of patients
*[[Janeway lesion]]s which are [[erythema]]tous, nontender lesions on palm or sole are present in 6% to 10% of patients

Revision as of 18:42, 20 March 2011

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Vital Signs

  • A fever will likely be present.
  • Rigors may be present.
  • Some patients may have a wide pulse pressure due to aortic insufficiency. If the pulse pressure narrows, this may be a sign of left ventricular failure due to earlier closure of the mitral valve and a more rapid rise in the left ventricular end diastolic pressure which will in turn raise the diastolic pressure.

Skin

  • Petechiae are present in 10% to 40% of patients
  • Splinter hemorrhages are present in 5% to 15% of patients
  • Osler's nodes which are tender subcutaneous nodules in pulp of digits are present in 7% to 10% of patients
  • Janeway lesions which are erythematous, nontender lesions on palm or sole are present in 6% to 10% of patients

Eyes

Roth's spots (white centered hemorrhage)


Ear Nose and Throat

In patients in whom there is new acute onset of aortic regurgitation, bobbing of the uvula may be present.

Heart

Lungs

Abdomen

  • Abdominal pain may be present due to mesenteric embolization or ileus both of which may manifest as reduced bowel sounds
  • Splenomegaly may be present in 15% to 30% patients.
  • Left upper quadrant (LUQ) pain may be present as a result of a splenic infarct from embolization.
  • Flank pain may be present as a result of an embolus to the kidney

Extremities

Osler's nodes


Neurologic

References

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