Type of endocarditis presenting with fever and new cardiac murmur

 Cardiology  MRCP

Rheumatic feverInfective endocarditis
causeAutoimmune-mediated (Type II hypersensitivity) following Streptococcus pyogenes sore throat.Largely bacterial (Staphylococci / Streptococci)
pathology findingsAschoff bodies. Valvular leaflet thickening. 'Warty' changes on valves.Vegetations on cardiac valves
presentationSub-acute following scarlet fever / Streptococcal sore throatShort (< 6 weeks) or long incubation
diagnosisModified Jones criteriaModified Duke criteria
preventionTreating Streptococcal sore throat with antibiotics and antibiotic prophylaxis in those at riskAntibiotic prophylaxis in those at risk
skin lesionserythema marginatumOsler's nodes, Janeway lesions
other featuresSydenham's chorea, long PR interval on ECG, Carey Coombs murmurSeptic emboli, glomerulonephritis, Roth's spots
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Further reading Rheumatic fever and Infective endocarditis


Eponymous cardiac murmurs | Valvular heart disease | Emphysema | Hypertensive retinopathy | Jaundice | Granulomatous mycobacterial infections of the skin | Familial hyperlipidaemias | Loss of consciousness | Hyperparathyroidism classification | Chest pain | Motor defects | Inflammatory bowel disease | Cutaneous infestations | Hyponatraemia | Renal tubular acidosis types | Oligomenorrhoea and amenorrhoea |