INFECTIVE ENDOCARDITIS

A common mnemonic for the signs and symptoms of endocarditis is FROM JANE:
Fever
Roth's spots
Osler's nodes
Murmur
Janeway lesions
Anemia
Nail hemorrhage (splinter hemorrhages)
Emboli

Janeway lesions

 Janeway lesions (nontender, macular lesions most commonly involving the palms and soles). Janeway lesions occur more frequently in endocarditis caused by Staphylococcus aureus. Janeway lesions are caused by septic emboli. Subcutaneous abscesses are found on histologic examination.

Oslers nodes

Osler nodes: Osler’s nodes are painful, palpable, erythematous lesions most often involving the pads of the fingers and toes. Caused by immune complexes

Roth spots

Roth's spots are retinal hemorrhages with white or pale centers composed of coagulated fibrin.

Roth spots are also due to immune complexes (immune vasculitis)

Splinter haemorrhage

Splinter Haemorrhages are narrow, red to reddish-brown lines of blood beneath the nails. 

They run in the direction of nail growth and are named splinter hemorrhages because they look like a splinter beneath the fingernail. 

The hemorrhages may be caused by tiny clots that damage the small capillaries under the nails or  by vessel damage from swelling of the blood vessels (vasculitis). 

The most common cause for splinter hemorrhages is .trauma to the nail

DUKES CRITERIA

BE FEVEER
(*BE - Bacterial Endocarditis)

Major:
B = blood culture +ve >2 times 12 hr part 
E = Endocardial involvement from Echo 


Minor:
F = Fever 
E = Echo findings (not fulfilling a major) 
V = Vascular findings
EE = Evidences from microbiological/immunology (2 evidences)
R = Risk factors/predisposing factors - drug abuse, valvular diseases

RHEUMATIC FEVER

Rheumatic fever: Jones criteria · Major criteria: CANCER:
Carditis
Arthritis
Nodules
Chorea
Erythema
Rheumatic anamnesis
· Minor criteria: CAFE PAL:
CRP increased
Arthralgia
Fever
Elevated ESR
Prolonged PR interval
Anamnesis of rheumatism(Previous RF or RHD)
Leucocytosis

 Erythema marginatum  A long-lasting reddish Rash that begins on the trunk or arms as  macules which spread outward and clear in the middle to form rings, which continue to spread and coalesce with other rings, ultimately taking on a snake-like appearance. This rash typically spares the face and is made worse with heat.

Subcutaneous nodules: Painless, firm collections of collagen fibers over bones or tendons. occur commonly on extenor surfaces