Endocarditis

This morning we discussed a case of subacute bacterial endocarditis secondary to Strep viridans.

Here is a previous post on endocarditis with some great review referrences.

* Viridans Streptococcus is a term for a large group of commensal streptococcal bacteria that are either α-hemolytic, producing a green coloration on blood agar plates (hence the name "viridans", from Latin "vĭrĭdis", green), or nonhemolytic.

Stigmata of Endocarditis

HoPingKong-isms:
1. "can you hear me?!!?!?" (speaking loudly): referring to ototoxicity with heavy gentamicin use .
2. "are you a sensitive person?" referring to a desensitization protocol that can be done under close observation with allergies to antibiotics such as penicillin.
3. "let me give you a preamble" referring to the presystolic accentuation of the murmur of mitral stenosis

Peripheral stigmata of infective endocarditis:
(Remember the Duke Criteria for diagnosis).

Vascular phenomena - major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhages, conjunctival hemorrhages, Janeway lesions (not painful, on hands/feet)

Immunologic phenomena - glomerulonephritis, Osler's nodes (painful, on hands/feet), Roth spots, positive rheumatoid factor


















Janeway lesion on the left, and Oslers node on the right.