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Urine analysis - microhematuria with or without proteinuria may be seen.
ECG - All patients with suspected IE should have baseline and follow up ECG which may reveal conduction disturbances reflecting intramyocardial extension of infection, ranging from a prolonged PR interval to complete heart block (especially with PVE). A new atrioventricular block carries a 77 per cent positive predictive value for abscess formation with 42 per cent sensitivity. Myocardial infarction due to embolization of vegetations occur rarely.
Chest X-ray - may reveal congestive heart failure or pleural effusions. Right sided IE may cause nonspecific infiltrates due to multiple septic pulmonary emboli.
Culture negative mimics of IE - atrial myxoma, a/c rheumatic fever/SLE, Antiphospholipid antibody syndrome, marantic endocarditis, carcinoid syndrome and Thrombotic thrombocytopenic purpura.
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How can an adult lose billions of cells from all parts of the body each day and still survive?
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