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Infective endocarditis is associated with 18% in-hospital mortality. [24] However, adult patients with congenital heart disease can have relatively lower mortality down to 5% due to younger age, right-sided endocarditis and management by multidisciplinary teams. As many as 50% of people with infective endocarditis may experience embolic ...
[4] 10–25% of endocarditis patients will have Osler's nodes. [5] Other signs of endocarditis include Roth's spots and Janeway lesions. The latter, which also occur on the palms and soles, can be differentiated from Osler's nodes because they are non-tender. [3] Osler's nodes can also be seen in Systemic lupus erythematosus; Marantic endocarditis
Other strains of streptococci can cause subacute endocarditis as well. These include streptococcus intermedius, which can cause acute or subacute infection (about 15% of cases pertaining to infective endocarditis). [7] Enterococci from urinary tract infections and coagulase negative staphylococci can also be causative agents. [5]
Diagnosing the cause of infective endocarditis, typically involves getting positive blood culture, which is literally growing bacteria from a blood sample. Echocardiography can also be used to visualize the heart and look for vegetations or more subtle clues like the way the valve’s moving.
Another form of sterile endocarditis is termed Libman–Sacks endocarditis; this form occurs more often in patients with lupus erythematosus and is thought to be due to the deposition of immune complexes. [2] Like NBTE, Libman-Sacks endocarditis involves small vegetations, while infective endocarditis is composed of large vegetations. [2]
Janeway lesions present as red, painless macules and papules on the palms and soles. [2]They are not common and are frequently indistinguishable from Osler's nodes.Rarely, they have been reported in cases of systemic lupus erythematosis (SLE), gonococcemia (disseminated gonorrhoea), haemolytic anaemia and typhoid fever.
The pain is usually relieved by sitting up or bending forward, and worsened by lying down (both recumbent and supine positions) or by inspiration (taking a breath in). [11] The pain may resemble that of angina but differs in that pericarditis pain changes with body position, where heart attack pain is generally constant and pressure-like.
The HACEK organisms are a group of fastidious Gram-negative bacteria that are an unusual cause of infective endocarditis, which is an inflammation of the heart due to bacterial infection. [1] HACEK is an abbreviation of the initials of the genera of this group of bacteria: Haemophilus , Aggregatibacter (previously Actinobacillus ...