What is bacterial endocarditis?
Bacterial endocarditis is the infection of the layer of cardiac tissue called the endocardium or endoarterium. It is caused when bacteria infect heart valves (both native and prosthetic) and cause vegetations to form. These vegetations can break off, get pumped into the circulation and get lodged in blood vessels blocking blood flow to tissues downstream (embolization). These little vegetations and vessel occlusions can cause cutaneous manifestations of the disease. Symptoms of bacterial endocarditis are generalized and include fever, chills/sweats and weight loss. Cutaneous signs of endocarditis include:
What causes bacterial endocarditis?
Bacterial endocarditis is caused by bacterial adherence to damaged heart valves. This can occur on both native and prosthetic heart valves.
How is bacterial endocarditis treated?
Preventative treatment measures are taken in patients with known risks such as prosthetic valves. These patients are given antibiotic therapy prior to certain procedures that increase their chance of getting a blood infection, such as dental procedures. Once the diagnosis of bacterial endocarditis is made therapy includes intravenous antibiotics and in severe cases surgery for valve replacement.
Figure 1 (left): Janeway lesions on the palm of the hand. Figure 2 (right): Splinter hemorrhages
Wolff K, Johnson, RA. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology. Sixth Edition. 2009.