Osler nodes

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.

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

• New murmer may suggest infective endocarditis

• 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

• X-ray for septic emboli

• Echo for endocarditis and valvular disorders

• Meningococcemia – IV antibiotics, antibiotic prophylaxis

• Bacterial endocarditis – Long term antibiotics

• Bacterial endocarditis – valve replacement (subjective)

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