Infective endocarditis involves microbial colonization of cardiac valvular endothelium. Clinical presentation combines persistent bacteremia, valvular regurgitation, and peripheral immunologic or vascular phenomena.
Present in >90% of patients, frequently accompanied by night sweats and rigors.
Round white retinal hemorrhages with pale, white fibrin centers caused by retinal immune complex deposition.
Painful, tender, erythematous nodules on pads of fingers and toes (immune complex deposits; 'O for Ouch').
New regurgitant murmur (especially mitral or aortic) indicates ongoing valvular destruction.
Non-tender, small, erythematous macules on palms and soles caused by septic microemboli.
Normocytic normochromic anemia of chronic disease and immune-mediated joint aches.
Linear dark reddish-brown subungual streaks from microvascular thrombotic emboli.
Major arterial emboli, septic pulmonary infarcts, mycotic aneurms, or conjunctival hemorrhages.