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Endocarditis - Symptom

Alternative Names

Valve infection

Symptoms:

Abnormal urine color
Chills (common)
Excessive sweating (common)
Fatigue
Fever (common)
Joint pain
Muscle aches and pains
Night sweats
Nail abnormalities (splinter hemorrhages under the nails)
Paleness
Red, painless skin spots on the palms and soles (Janeway lesions)
Red, painful nodes in the pads of the fingers and toes (Osler's nodes)
Shortness of breath with activity
Swelling of feet, legs, abdomen
Weakness
Weight loss

Note: Endocarditis symptoms can develop slowly (subacute) or suddenly (acute).

Signs and tests:

Doctors might suspect endocarditis in people with a history of:

Congenital heart disease
Intravenous drug use
Recent dental work
Rheumatic fever

The health care provider may detect a new heart murmur, or a change in a previous heart murmur. Examination of the nails may show splinter hemorrhages.

An eye exam may show bleeding in the retina a central area of clearing. This is known as Roth's spots. There may be small, pinpoint hemorrhages (petechiae) in the conjunctiva. The fingertips may be enlarged, and the nails may appear curved. This is called clubbing.

Tests:

Heart, section through the middle

Heart, front view

Janeway lesion - close-up

Janeway lesion on the finger

Heart valves

Reviewed last on: 9/3/2008
D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. London: Churchill Livingstone; 2005; pp 975-1022.

Karchmer AW. Infective Endocarditis. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007:chap 63.

Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007 Oct 9;116(15):1736-54.

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