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Other strains of streptococci can cause subacute endocarditis as well. These include streptococcus intermedius, which can cause acute or subacute infection (about 15% of cases pertaining to infective endocarditis). [7] Enterococci from urinary tract infections and coagulase negative staphylococci can also be causative agents. [5]
The nodes are commonly indicative of subacute bacterial endocarditis. [4] 10–25% of endocarditis patients will have Osler's nodes. [5] Other signs of endocarditis include Roth's spots and Janeway lesions. The latter, which also occur on the palms and soles, can be differentiated from Osler's nodes because they are non-tender. [3]
Infective endocarditis is divided into the three categories of acute, subacute, and chronic based on the duration of symptoms. [11] Acute infective endocarditis refers to the presence of signs and symptoms of infective endocarditis that are present for days up to six weeks. [11]
Endocarditis is characterized by lesions, known as vegetations, which are masses of platelets, fibrin, microcolonies of microorganisms, and scant inflammatory cells. [1] In the subacute form of infective endocarditis, a vegetation may also include a center of granulomatous tissue, which may fibrose or calcify. [2]
Janeway lesions present as red, painless macules and papules on the palms and soles. [2]They are not common and are frequently indistinguishable from Osler's nodes.Rarely, they have been reported in cases of systemic lupus erythematosis (SLE), gonococcemia (disseminated gonorrhoea), haemolytic anaemia and typhoid fever.
Myocarditis can be distinguished as either fulminant or acute based on the severity of symptoms on presentation, as well as the time course over which symptoms develop and persist. This categorization can help predict the treatment, outcomes, and complications of myocarditis. [citation needed]
Splinter hemorrhages (or haemorrhages) are tiny blood clots that tend to run vertically under the nails.Splinter hemorrhages are not specific to any particular condition, and can be associated with subacute infective endocarditis, scleroderma, trichinosis, systemic lupus erythematosus (SLE), rheumatoid arthritis, psoriatic nails, [1] antiphospholipid syndrome, [2]: 659 haematological ...
Roth's spots, also known as Litten spots or the Litten sign, [1] are non-specific red lesions with white or pale centres, seen on the retina of the eye and although traditionally associated with infective endocarditis, can occur in a number of other conditions including hypertension, diabetes, collagen vascular disease, extreme hypoxia, leukemia and HIV.