RT Book, Section A1 Hardin, J. Matthew A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181043818 T1 Infective Endocarditis T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181043818 RD 2024/10/09 AB Infective endocarditis (IE) is characterized by infection of the endocardium (including the valves, mural endocardium, or septal defect) manifested by many cutaneous findings. Causes are diverse and can be broadly categorized as (1) acute and subacute native valve IE, (2) early and late prosthetic valve IE, (3) intravenous (IV) drug abuse IE, and (4) iatrogenic IE. The latter is associated with recent hospital admission or a procedure causing bacteremia or endocardial damage. Staphylococcus aureus is the most common causative organism, but many other bacteria and fungi are implicated. Janeway lesions (septic emboli forming microabscesses) are nontender, small, erythematous (occasionally with central hemorrhage) macules on the palms or soles. Osler nodes (immune complex deposition resulting in small-vessel vasculitis) consist of transient, tender, purplish nodules on the pulp of the fingers and toes. Subungual splinter hemorrhages are black, linear discolorations beneath the conjunctiva and nail plate. Murmurs, retinal hemorrhages, septic arthritis, and significant embolic episodes such as pulmonary embolism or cerebral vascular embolism may also be present.