Osler nodes

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview[edit | edit source]

Osler node is a characteristic of subacute bacterial endocarditis. It is small, papulopustular/nodular & tender cutaneus lesion. There is controversy about the exact origin of the lesion.

Differential Diagnosis[edit | edit source]

In alphabetical order. ^{[1] [2]}

• Acute bacterial endocarditis
• Cutaneous vasculitis
• Disseminated intravascular coagulation
• Enteroviral infection
• Idiopathic thrombocytopenia purpura
• Meningococcemia
• Rocky mountain spotted fever
• Subacute bacterial endocarditis
• Syphillis
• Systemic lupus erythematosus

Diagnosis[edit | edit source]

Physical examination[edit | edit source]

Heart[edit | edit source]

• New murmer may suggest infective endocarditis

Laboratory Findings[edit | edit source]

• Labs include:

• ANA
• anti-dsDNA
• anti-SM antibodies
• Biopsy of lesions
• Blood cultures
• CBC
• Coagulation studies
• Peripheral smear

• TTP - schistocytes on blood smear, increased LDH & indirect bilirubin
• ITP - platelet-associated IgG test

• Urinalysis

Chest X Ray[edit | edit source]

• X-ray for septic emboli

Echocardiography or Ultrasound[edit | edit source]

• Echo for endocarditis and valvular disorders

Treatment[edit | edit source]

Acute Pharmacotherapies[edit | edit source]

• Meningococcemia - IV antibiotics, antibiotic prophylaxis

Chronic Pharmacotherapies[edit | edit source]

• Bacterial endocarditis - Long term antibiotics

Indications for Surgery[edit | edit source]

• Bacterial endocarditis - valve replacement (subjective)

References[edit | edit source]

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