Endocarditis history and symptoms
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editors-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]
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Symptoms Frequency Across All Subtypes of Endocarditis
- Fever 80 - 85%, often spiking
- 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
Subacute Bacterial Endocarditis (SBE)
- Insidious onset
- Fever
- Sweats
- Weakness
- Myalgias
- Arthralgias
- Malaise
- Anorexia
- Fatigue
- Splenomegaly, clubbing, and Oslers nodes in long-standing SBE
Acute Bacterial Endocarditis
Endocarditis Associated with Parenteral Drug Use
- High fevers, chills, rigors, malaise, cough, and pleuritic chest pain
- Septic pulmonary emboli causing sputum production, hemoptysis, and signs suggesting pneumonia
- Cardiac murmurs
- Tricuspid insufficiency
- Metastatic infections such as renal or brain abscess
- Neurologic manifestations such as stroke, TIA, seizures
- Peripheral emboli
Prosthetic Valve Endocarditis
- Occurs in 1%–2% of cases at 1 yr and in 4%–5% of cases at 4 yr after implantation
- Infection of perivalvular tissues
- New symptoms consistent with valvular regurgitation such as shortness of breath
- Myocardial abscesses
- Fever
- Petechiae, Roth's spots, Osler's nodes, Janeway lesions
- Emboli