Infective endocarditis is characterised by insidious onset of fever, malaise, night- sweats and weight loss. Other signs include vomiting, fatigue, headache, myalagia and arthralgia, splenomegaly, and Petechia. There will be a characteristic heart murmur because of destruction of valves, damage to myocardium or congesive heart failure,
In the later course of disease there may be small erythematous lesions on the palm and soles. There will be splinter haemorhage (these are darkened lines under the nails) and tender small dermal nodules in pads of the fingers and toes called ostenodes. Nursing Management Diagnostic evaluation includes laboratory examination of blood which shows elevated of Children with erythrocyte sedimentation rate (ESR) and anaeinia, mild to moderate leukocytosis. X- Medical and Surgical ray shows cardiomegaly, ECG shows prolonged PR interval. Echocardiography reveals presence of vegetation and ultrasound demonstrates the effects of valvular incompetence. Blood is also obtained for culture and sensitivity.