- 80% staph, strep
- Other less common organisms HACEK, Coxiella, T Whiplei, fungal
- Prior endocarditis
- Unrepaired cyanotic congenital heart dz
- Prosthetic valve
- Acquired R sided valvular heart dz (in particular, tricuspid)
- Lightheadedness, dizzy, confused (sepsis)
- Systemic embolic events w/seeding and assoc sx
- Sob w/septic emboli to lung w/infection of right sided (tricuspid) valves
- Rapidity of clinical progression affected by organism and pt substrate
- New or worse murmur of TR
- Relatively rare skin findings include Janeway lesions→flat, painless, erythematous lesions on hands
- Osler's nodes→ painful nodules on fingers, findings associated w/seeding→ e.g. lbp or neuro findings from vertebral osteo, epidural abscess
- Focal neuro deficits from stroke or brain abscess
- Lung findings of infiltrate
- Pleural effusion
- Chf (edema, elevated jvp); R sided findings may predominate
- + blood cultures
- CT chest
- Echo w/vegetations