h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

IE can be caused by a great number of bacteria (in fact just about any bacteria!) - those mentioned are the commonest, but those bugs found in the mouth can be a cause of IE - such as streptococcus oralis. It is always worth checking dental health if you suspect somebody has endocarditis. Another group of organisms which can cause endocarditis are the HACEK organsims.

The classical symptoms of endocarditis are: Fevers, night sweats, fatigue, a heart murmur (which may change in characteristic from one day to the next). The little lumps found on the fingers are called Osler's nodes.

True, true, the classical symptom group is decidedly rare in practice though.

There are also other signs on the hands on the sides of the palm called Janeway lesions which look like small round red spots. Similar spots caused by minute blood vessels bleeding are seen in the mouth and on the retina called Roth spots.

Xuenyl

Had a patient the other day with Janeway Lesions and Osler's Nodes, along with splinter haemorrhages et al. He's been keeping the medical students busy for the last few days!

Lucky him! I was in Sydney fairly recently and saw quite a few cases in IV drug users with massive vegetations on the tricuspid and a tendency to self discharge when they needed another hit before being re-admitted days later when their symptoms got worse again and they remembered that they needed antibiotics. Not sensible really.