What are classic signs of infective endocarditis (IE)?

Updated: Jan 03, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Fever, possibly low-grade and intermittent, is present in 90% of patients with IE. Heart murmurs are heard in approximately 85% of patients.

One or more classic signs of IE are found in as many as 50% of patients. They include the following:

  • Petechiae: Common, but nonspecific, finding

  • Subungual (splinter) hemorrhages: Dark-red, linear lesions in the nail beds

  • Osler nodes: Tender subcutaneous nodules usually found on the distal pads of the digits

  • Janeway lesions: Nontender maculae on the palms and soles

  • Roth spots: Retinal hemorrhages with small, clear centers; rare


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