Consequences of valvular vegetations
An infected valvular vegetation may result in four consequences which together produce the clinical and pathological picture.
- bacteraemia and/or septicaemia:
- this may cause fever, malaise, anorexia, weight loss, leucocytosis, anaemia, a raised ESR, a raised CRP, splenomegaly
- this may cause fever, malaise, anorexia, weight loss, leucocytosis, anaemia, a raised ESR, a raised CRP, splenomegaly
- production of circulating immune complexes:
- these may lead to splinter haemorrhages, Osler's nodes, Janeway lesions or glomerulonephritis
- these may lead to splinter haemorrhages, Osler's nodes, Janeway lesions or glomerulonephritis
- local destruction of cardiac tissue:
- this may lead to valvular incompetence, heart failure, cardiac conduction abnormalities, abscess formation, fistulas between right and left sides of the heart
- disappearance of the first heart sound may signify aortic incompetence
- peripheral emboli:
- these may cause strokes, splenic or renal infarction and mycotic aneurysms
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