Osler nodes

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

## Contents

* 1 Overview
* 2 Differential Diagnosis
* 3 Diagnosis
* 3.1 Physical examination
* 3.2 Heart
* 4 Laboratory Findings
* 4.1 Chest X Ray
* 4.2 Echocardiography or Ultrasound
* 5 Treatment
* 5.1 Acute Pharmacotherapies
* 5.2 Chronic Pharmacotherapies
* 5.3 Indications for Surgery
* 6 References

## 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]

1. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
2. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

Template:WikiDoc Sources