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Clinical manifestations of Infective Endocarditis

Fever is the most common manifestation of Infective Endocarditis (IE).
Heart murmurs are seen in 80 - 85% of cases
Enlargement of spleen is seen in 15 - 50% of cases.

Peripheral manifestations of IE are 
1. Petechiae is the most common peripheral sign
Palpebral conjunctiva, the buccal and palatal mucosa, and the extremities are the common sites of Petechiae

2. Splinter Hemorrhages
It is nonspecific and nonblanching 
Appear as linear reddish-brown lesions found under the nail bed
Usually do not extend the entire length of the nail

3. Osler’s Nodes
More specific for IE
Painful and erythematous nodules
Located on pulp of fingers and toes
More common in subacute IE
4 P’s related to oslers nodes are
Pulp of the fingers/toes

4. Janeway Lesions
More specific
Erythematous, blanching macules 
Located on palms and soles

Myalgia, arthralgia, back pain can be present in IE patients

Systemic embolisation manifest as neurological and renal involvement 
Neurological manifestations are embolic stroke (most common) and mycotic aneurysm.
Renal insufficiency, immune-complex mediated glomerulonephritis  embolic renal infarct can occur in IE.