When should I think about infective endocarditis and septic emboli?
-Consider in patients who raise your suspicion for sepsis and have any of these risk factors:
What exam findings are suggestive of IE?
-Some are more specific than others. Roth’s spots, Osler’s nodes, and Janeway lesions are relatively rare but are essentially illness defining. More sensitive but less specific findings include cardiac murmors, petechiae, splenomegaly, and splinter hemorrhages.
Who gets septic emboli?
-Patients with large lesions, unstable/multiple lesions, and left sided lesions are most likely to embolize secondary to higher left sided pressure gradients.
Where do the emboli go, and what does that look like?
- Right sided lesions (without PFO) go to the lungs, and typically manifest clinically as:
-Left Sided lesions
Take Home Points