Clinical Features

The symptoms and signs may be completely nonspecific, especially with myocardial abscesses. Patients usually experience vague fevers and chills but may present with more obvious sepsis. Frequently patients are given antibiotics on an outpatient basis for some presumed bacterial infection, such as bronchitis. Patients may be suspected of having valvular endocarditis and may be admitted to the hospital for intravenous antibiotics, and yet the correct diagnosis is not made and symptoms recur after discharge. Many symptoms, including positive blood culture results, peripheral embolization, and splenomegaly, are found in both valvular and nonvalvular infections of the heart. Frequently patients have sudden fatal complications, such as myocardial rupture, tamponade, or severe peripheral embolization, diagnoses made only at autopsy.

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