Valve infection

• Abnormal urine color
• Chills (common)
• Excessive sweating (common)
• Fatigue
• Fever (common)
• Joint pain
• Muscle aches and pains
• Night sweats
• Nail abnormalities (splinter hemorrhages under the nails)
• Paleness
• Red, painless skin spots on the palms and soles (Janeway lesions)
• Red, painful nodes in the pads of the fingers and toes (Osler's nodes)
• Shortness of breath with activity
• Swelling of feet, legs, abdomen
• Weakness
• Weight loss

Note: Endocarditis symptoms can develop slowly (subacute) or suddenly (acute).

Doctors might suspect endocarditis in people with a history of:

• Congenital heart disease
• Intravenous drug use
• Recent dental work
• Rheumatic fever

The health care provider may detect a new heart murmur, or a change in a previous heart murmur. Examination of the nails may show splinter hemorrhages.

An eye exam may show bleeding in the retina a central area of clearing. This is known as Roth's spots. There may be small, pinpoint hemorrhages (petechiae) in the conjunctiva. The fingertips may be enlarged, and the nails may appear curved. This is called clubbing.

Tests:

• Blood culture
• Complete blood count (CBC)
• Chest x-ray
• C-reactive protein (CRP)
• Echocardiogram
• ECG
• Erythrocyte sedimentation rate (ESR)
• Serology
• Transesophageal echocardiogram

Images

Janeway lesion - close-up

Heart, front view

Janeway lesion on the finger

Review Date: 04/27/2010
Reviewed By: Daniel Levy, MD, Infectious Disease, Maryland Family Care, Lutherville, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)