Clinical Manifestations

i) Evidence of Systemic Infection

Fever, chills, rigor, night sweat, loss of weight, arthralgia, arthritis, backache, muscle pain. 

ii) Evidence of Intra-vascular Lesions

1. Splinter haemorrhages (black longitudinal streaks) that may occur in the nail beds. 
2. Petechiae common in conjunctivae, lips buccal mucosa, over ankles, feet and the antecubital and popliteal areas. 
3. Osler's nodes (painful, tender, red or purple, pea-sized lesions) seen on the fingertips or toes. 
4. Janeway's lesions-flat, painless small red spot on the palms and soles. 
5. Fundoscopic examination may reveal haemorrhagic retinal lesions (Roth's spots). 
6. Heart murmur is seen if aortic and mitral valves are affected. Patient may go into heart failure.