Endocarditis history and symptoms: Difference between revisions

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{{Endocarditis}}
{{Endocarditis}}


{{CMG}}; '''Associate Editors-in-Chief:''' {{CZ}}
{{CMG}}; {{AE}} {{Maliha}} {{CZ}}


==Symptoms Frequency  Across All Subtypes of Endocarditis==
==Overview==
Common [[Symptom|symptoms]] of [[endocarditis]] include [[fever]], [[chills]], [[anorexia]], [[malaise]], [[weight loss]], and [[back pain]].


* [[Fever]] 80 - 85%, often spiking
==History and Symptoms==
* [[Chills]] 42 - 75%
* [[Anorexia]] 25 - 55%
* [[Malaise]] 25 - 40%
* [[Weight loss]] 25 - 35%
* [[Back pain]]
* [[Flank pain]] due to renal embolization
* [[Stroke]] may be present in 10 - 15% of patients as a result of cerebral embolization
* [[Chest pain]] may be present as a result of embolzation in the coronary artery. The infarcts are usually not transmural. Pulmonary emboli, often septic, occur in 75% of patients with tricuspid endocarditis
* [[Abdominal pain]] may be present due to mesenteric embolization or [[ileus]]
* [[Blindness]] may be present due to retinal embolization in 3% of patients


==History and Symptoms in Subtypes of Endocarditis==
=== History ===
===Subacute Bacterial Endocarditis (SBE)===
Patients with [[endocarditis]] may have a positive history of:<ref name="pmid3272238">{{cite journal |vauthors=Arvay A, Lengyel M |title=Incidence and risk factors of prosthetic valve endocarditis |journal=Eur J Cardiothorac Surg |volume=2 |issue=5 |pages=340–6 |date=1988 |pmid=3272238 |doi= |url=}}</ref><ref name="pmid11794152">{{cite journal| author=Mylonakis E, Calderwood SB| title=Infective endocarditis in adults. | journal=N Engl J Med | year= 2001 | volume= 345 | issue= 18 | pages= 1318-30 | pmid=11794152 | doi=10.1056/NEJMra010082 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11794152  }}</ref><ref name="CorrigallBolen1977">{{cite journal|last1=Corrigall|first1=Denton|last2=Bolen|first2=James|last3=Hancock|first3=E.William|last4=Popp|first4=Richard L.|title=Mitral valve prolapse and infective endocarditis|journal=The American Journal of Medicine|volume=63|issue=2|year=1977|pages=215–222|issn=00029343|doi=10.1016/0002-9343(77)90235-2}}</ref><ref name="SousaBotelho2012">{{cite journal|last1=Sousa|first1=C.|last2=Botelho|first2=C.|last3=Rodrigues|first3=D.|last4=Azeredo|first4=J.|last5=Oliveira|first5=R.|title=Infective endocarditis in intravenous drug abusers: an update|journal=European Journal of Clinical Microbiology & Infectious Diseases|volume=31|issue=11|year=2012|pages=2905–2910|issn=0934-9723|doi=10.1007/s10096-012-1675-x}}</ref><ref name="SohailUslan2008">{{cite journal|last1=Sohail|first1=Muhammad R.|last2=Uslan|first2=Daniel Z.|last3=Khan|first3=Akbar H.|last4=Friedman|first4=Paul A.|last5=Hayes|first5=David L.|last6=Wilson|first6=Walter R.|last7=Steckelberg|first7=James M.|last8=Jenkins|first8=Sarah M.|last9=Baddour|first9=Larry M.|title=Infective Endocarditis Complicating Permanent Pacemaker and Implantable Cardioverter-Defibrillator Infection|journal=Mayo Clinic Proceedings|volume=83|issue=1|year=2008|pages=46–53|issn=00256196|doi=10.4065/83.1.46}}</ref><ref name="MoyssakisTektonidou2007">{{cite journal|last1=Moyssakis|first1=Ioannis|last2=Tektonidou|first2=Maria G.|last3=Vasilliou|first3=Vassilios A.|last4=Samarkos|first4=Michael|last5=Votteas|first5=Vassilios|last6=Moutsopoulos|first6=Haralampos M.|title=Libman-Sacks Endocarditis in Systemic Lupus Erythematosus: Prevalence, Associations, and Evolution|journal=The American Journal of Medicine|volume=120|issue=7|year=2007|pages=636–642|issn=00029343|doi=10.1016/j.amjmed.2007.01.024}}</ref><ref name="MinGyorkey1980">{{cite journal|last1=Min|first1=Kyung-Whan|last2=Gyorkey|first2=Ferene|last3=Sato|first3=Clifford|title=Mucin-producing adenocarcinomas and nonbacterial thrombotic endocarditis. Pathogenetic role of tumor mucin|journal=Cancer|volume=45|issue=9|year=1980|pages=2374–2382|issn=0008-543X|doi=10.1002/1097-0142(19800501)45:9<2374::AID-CNCR2820450923>3.0.CO;2-J}}</ref>
* Insidious onset
* [[Fever]]
* [[Sweat]]s
* [[Weakness]]
* [[Myalgia]]s
* [[Arthralgia]]s
* [[Malaise]]
* [[Anorexia]]
* [[Fatigue]]
* [[Splenomegaly]], [[clubbing]], and [[Osler’s nodes]] in long-standing SBE


===Acute Bacterial Endocarditis===
*Any [[congenital heart disease]]
*[[Valvular heart diseases|Valvular heart disease]]
*[[Intravenous]] [[drug abuse]]
*[[Prosthetic heart valves]]
*[[Intracardiac]] devices
*[[Immunosuppression]]
*Poor [[dental]] health and history of recent [[dental]] procedures
*[[Lupus]]
*[[Malignancy]]


*Abrupt onset
=== Common Symptoms ===
* [[Rigors]]
[[Subacute bacterial endocarditis]] has an insidious onset while [[acute bacterial endocarditis]] is abrupt in onset.
* [[Fever]]s as high as 102.9° to 105.1° F (39.4° to 40.6° C), often remittent


===Endocarditis Associated with Parenteral Drug Use===
=====Bacterial Endocarditis=====
* [[fever|High fever]]s, [[chills]], [[rigors]], [[malaise]], [[cough]], and [[chest pain|pleuritic chest pain]]
Common [[Symptom|symptoms]] of [[endocarditis]] include:<ref name="pmid11830803">{{cite journal| author=Dhawan VK| title=Infective endocarditis in elderly patients. | journal=Clin Infect Dis | year= 2002 | volume= 34 | issue= 6 | pages= 806-12 | pmid=11830803 | doi=10.1086/339045 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11830803  }} </ref><ref name="pmid12695478">{{cite journal| author=Moss R, Munt B| title=Injection drug use and right sided endocarditis. | journal=Heart | year= 2003 | volume= 89 | issue= 5 | pages= 577-81 | pmid=12695478 | doi= | pmc=PMC1767660 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12695478  }} </ref><ref name="pmid18082531">{{cite journal |vauthors=Silverman ME, Upshaw CB |title=Extracardiac manifestations of infective endocarditis and their historical descriptions |journal=Am. J. Cardiol. |volume=100 |issue=12 |pages=1802–7 |date=December 2007 |pmid=18082531 |doi=10.1016/j.amjcard.2007.07.034 |url=}}</ref><ref name="pmid24500311">{{cite journal |vauthors=Servy A, Valeyrie-Allanore L, Alla F, Lechiche C, Nazeyrollas P, Chidiac C, Hoen B, Chosidow O, Duval X |title=Prognostic value of skin manifestations of infective endocarditis |journal=JAMA Dermatol |volume=150 |issue=5 |pages=494–500 |date=May 2014 |pmid=24500311 |doi=10.1001/jamadermatol.2013.8727 |url=}}</ref>
* [[pulmonary emboli|Septic pulmonary emboli]] causing [[sputum]] production, [[hemoptysis]], and signs suggesting [[pneumonia]]
* [[murmur|Cardiac murmurs]]
* [[Tricuspid insufficiency]]
* Metastatic infections such as renal or brain abscess
* Neurologic manifestations such as [[stroke]], [[TIA]], [[seizures]]
* Peripheral emboli


===Prosthetic Valve Endocarditis===
*[[Rigors]]
* Occurs in 1%–2% of cases at 1 yr and in 4%–5% of cases at 4 yr after implantation
*[[Fever]]s as high as 102.9° to 105.1° F (39.4° to 40.6° C), often remittent
* Infection of perivalvular tissues
*[[Chills]]
* New symptoms consistent with valvular regurgitation such as [[shortness of breath]]
*[[Anorexia]]
* [[abscess|Myocardial abscesses]]
*[[Malaise]]
* [[Fever]]
*[[Fatigue ]]
* [[Petechiae]], [[Roth's spot]]s, [[Osler's nodes]], [[Janeway lesion]]s
*[[Weight loss]]
* [[Emboli]]
*[[Back pain]]
*[[Flank pain]] due to renal [[embolization]].
*[[Stroke]] may be present in 10 - 15% of patients as a result of [[cerebral]] [[embolization]]
*[[Chest pain]] may be present as a result of [[embolization]] in the [[coronary artery]]. The infarcts are usually not [[Transmural care|transmural]]. [[Pulmonary emboli]], often [[septic]], occur in 75% of patients with [[tricuspid]] [[endocarditis]]
*[[Abdominal pain]] may be present due to [[mesenteric]] [[embolization]] or [[ileus]]
*[[Blindness]] may be present due to [[retinal]] [[embolization]] in 3% of patients
 
=====Endocarditis Associated with Parenteral Drug Use=====
Common symptoms of endocarditis in intravenous drug abusers are:
 
*[[fever|High fever]]
*[[Chills]]
*[[Rigors]]
*[[Malaise]]
*[[Cough]]  
*[[chest pain|Pleuritic chest pain]]
*[[Sputum]] production, [[hemoptysis]]
*[[Stroke]], [[TIA]], [[seizures]]
 
=====Prosthetic Valve Endocarditis=====
 
*[[Shortness of breath]]
*[[Fever]]
*[[Petechiae]]


==References==
==References==
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[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Infectious disease]]
 
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date]]

Latest revision as of 21:51, 3 March 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2] Cafer Zorkun, M.D., Ph.D. [3]

Overview

Common symptoms of endocarditis include fever, chills, anorexia, malaise, weight loss, and back pain.

History and Symptoms

History

Patients with endocarditis may have a positive history of:[1][2][3][4][5][6][7]

Common Symptoms

Subacute bacterial endocarditis has an insidious onset while acute bacterial endocarditis is abrupt in onset.

Bacterial Endocarditis

Common symptoms of endocarditis include:[8][9][10][11]

Endocarditis Associated with Parenteral Drug Use

Common symptoms of endocarditis in intravenous drug abusers are:

Prosthetic Valve Endocarditis

References

  1. ↑ Arvay A, Lengyel M (1988). "Incidence and risk factors of prosthetic valve endocarditis". Eur J Cardiothorac Surg. 2 (5): 340–6. PMID 3272238.
  2. ↑ Mylonakis E, Calderwood SB (2001). "Infective endocarditis in adults". N Engl J Med. 345 (18): 1318–30. doi:10.1056/NEJMra010082. PMID 11794152.
  3. ↑ Corrigall, Denton; Bolen, James; Hancock, E.William; Popp, Richard L. (1977). "Mitral valve prolapse and infective endocarditis". The American Journal of Medicine. 63 (2): 215–222. doi:10.1016/0002-9343(77)90235-2. ISSN 0002-9343.
  4. ↑ Sousa, C.; Botelho, C.; Rodrigues, D.; Azeredo, J.; Oliveira, R. (2012). "Infective endocarditis in intravenous drug abusers: an update". European Journal of Clinical Microbiology & Infectious Diseases. 31 (11): 2905–2910. doi:10.1007/s10096-012-1675-x. ISSN 0934-9723.
  5. ↑ Sohail, Muhammad R.; Uslan, Daniel Z.; Khan, Akbar H.; Friedman, Paul A.; Hayes, David L.; Wilson, Walter R.; Steckelberg, James M.; Jenkins, Sarah M.; Baddour, Larry M. (2008). "Infective Endocarditis Complicating Permanent Pacemaker and Implantable Cardioverter-Defibrillator Infection". Mayo Clinic Proceedings. 83 (1): 46–53. doi:10.4065/83.1.46. ISSN 0025-6196.
  6. ↑ Moyssakis, Ioannis; Tektonidou, Maria G.; Vasilliou, Vassilios A.; Samarkos, Michael; Votteas, Vassilios; Moutsopoulos, Haralampos M. (2007). "Libman-Sacks Endocarditis in Systemic Lupus Erythematosus: Prevalence, Associations, and Evolution". The American Journal of Medicine. 120 (7): 636–642. doi:10.1016/j.amjmed.2007.01.024. ISSN 0002-9343.
  7. ↑ Min, Kyung-Whan; Gyorkey, Ferene; Sato, Clifford (1980). "Mucin-producing adenocarcinomas and nonbacterial thrombotic endocarditis. Pathogenetic role of tumor mucin". Cancer. 45 (9): 2374–2382. doi:10.1002/1097-0142(19800501)45:9<2374::AID-CNCR2820450923>3.0.CO;2-J. ISSN 0008-543X.
  8. ↑ Dhawan VK (2002). "Infective endocarditis in elderly patients". Clin Infect Dis. 34 (6): 806–12. doi:10.1086/339045. PMID 11830803.
  9. ↑ Moss R, Munt B (2003). "Injection drug use and right sided endocarditis". Heart. 89 (5): 577–81. PMC 1767660. PMID 12695478.
  10. ↑ Silverman ME, Upshaw CB (December 2007). "Extracardiac manifestations of infective endocarditis and their historical descriptions". Am. J. Cardiol. 100 (12): 1802–7. doi:10.1016/j.amjcard.2007.07.034. PMID 18082531.
  11. ↑ Servy A, Valeyrie-Allanore L, Alla F, Lechiche C, Nazeyrollas P, Chidiac C, Hoen B, Chosidow O, Duval X (May 2014). "Prognostic value of skin manifestations of infective endocarditis". JAMA Dermatol. 150 (5): 494–500. doi:10.1001/jamadermatol.2013.8727. PMID 24500311.

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