Diagnosis of Active Infective Endocarditis from Examination of the Toes and Soles.
Resumen: A 72-year-old woman was admitted to our hospital with
fever >38 C of unknown origin. Blood cultures were positive
in 2 sets for Staphylococcus aureus. In the third day of
admission, her husband drew attention to the presence of
some small punctures in her right foot (Figure 1). Several
small and nontender, erythematous, and hemorrhagic macular
lesions were found on her sole (Janeway lesions). Besides,
we detected some painful and palpable, erythematous
nodules involving the pads of her toes (Osler nodes). At this
point, according to the modified Duke criteria, the clinical
diagnosis of definite infective endocarditis might be established.
In addition, the transesophageal echocardiogram just
confirmed the presence of a large vegetation attached to the
posterior leaflet of the mitral valve.
Although the diagnosis of infective endocarditis may be
challenged, sometimes there are simple clues: next time lift
the bed sheets!
Identificador universal: http://hdl.handle.net/10641/1265
Fecha: 2016
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