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.

PICTURES

Petichiae  (DO NOT BLANCHE !!!)

              

              

Splinter Hemorrhages

               

Roth Spots (retina)

                 

Janeway Lesions  (non-painful macules)

                 

Osler’s Nodes  (painful Nodules)