IE signs
OK, enough neurology cases for July. I will show you some classical signs of infective endocarditis.
SPLINCTER HAEMORRHAGE
subungual linear “vasculitic” lesions
OSLER’S NODES
red, raised tender nodules on the pulp of the fingers (or toes), or on the thenar or hypothenar eminences
ROTH’S SPOT
intraretinal haemorrhages with white centers representing fibrin thrombus occluding a rupture blood vessel
JANEWAY’S LESION
Non-tender, erythematous maculopapular lesions, containing bacteria, which occur very rarely on the palms and pulps of the fingers
CLUBBING
Labels: Cardiovascular
posted by Dr. David Teoh @ 7/30/2006 11:15:00 PM
2 Comments:
I would also advice a candidate to look in the conjuctivae carefully as splinter hemorrhages can be found there too. In fact I'm told this is the best place as splinter hemorrhages on fingers can actually be due to manual labour.
We are generally told that Janeway lesions are just septic emboli from the heart
Osler's nodes are said to be caused by immunologic reaction of host towards presence of immune mediated complexs deposited in the skin. However some researchers don't think so.
Check out this article for more information.
http://www.ecu.edu/intmedresidency/CurrentResidents/Clinical%20Signs/Peripheral%20Signs%20of%20Endocarditis.pdf
PS as to which one is the one that hurts, remember Osler=Ow! Ouch! is the one that hurts
Thx, Giant Eagle. It's a good article that describes the IE signs in detail.
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