Endocarditis (as cause of Arthralgias)

Fever:  Cardinal sign

Suspect:  Injection Drug User, Prosthetic Valve, Central Line

Auscultate Heart for new murmurs (esp. diastolic)

Seek signs of Septic Emboli (pictures below):
  • Petichiae (extremities, conjunctiva, palate)
  • Splinter Hemorrhages (nails)
  • Roth Spots (retina)
  • Janeway Lesions (palms & soles)
  • Osler’s Nodes (fingertips)

At-Risk patient with fevers needs admission for IV antibiotics pending blood culture results

See posting Polyarthralgias.


Petichiae  (DO NOT BLANCHE !!!)



Splinter Hemorrhages


Roth Spots (retina)


Janeway Lesions  (non-painful macules)


Osler’s Nodes  (painful Nodules)