19th June 2024

Clinical presentation

General features of infection include malaise, anorexia, weight loss and night sweats. Anaemia, clubbing and splenomegaly can occur in long standing infections. Cardiac manifestations of infection include congestive cardiac failure, palpitations, tachycardia, a new murmur and AV block.

In addition, patients may present with haemorrhagic manifestations. For instance, on the skin you may see petechiae, splinter haemorrhages, and small tender nodules on palms and soles of feet; pulp infarcts known as Osler’s nodes.

In the eye, you may see oval shaped retinal haemorrhages with a pale centre located near the optic disc, these are known as Roth spots. Conjunctival splinter haemorrhages and retinal flame haemorrhages may also be seen.

In the kidney, microscopic haematuria may be seen, with glomerulonephritis as a result of immune complex deposition. Cerebrally, you may also have toxic encephalopathy.