Corresponding author at: Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University College of Medicine, No.222, Maijin Rd., Anle Dist., Keelung City 204, Taoyuan, Taiwan R.O.C. Tel.: +886 2 2431 3131; fax: +886 3 328 7715.
Corresponding author at: Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University College of Medicine, No.222, Maijin Rd., Anle Dist., Keelung City 204, Taoyuan, Taiwan R.O.C. Tel.: +886 2 2431 3131; fax: +886 3 328 7715.
Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University College of Medicine, Taoyuan, Taiwan
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Figures
Fig. 1
Conjunctival hemorrhage.
Fig. 2
Conjunctival hemorrhage under slit lamp examination.
Fig. 3
Fundoscopy of the left eye disclosed a Roth's spot (arrow) and cherry-red spot (white arrow).
Fig. 4
Painless lesions on the palms (Janeway lesions); non-tender, erythematous lesions on the palms.
Fig. 5
Painful lesion on the finger pad (Osler's nodes).
Fig. 6
Janeway lesions (white arrow) over sole and Osler's nodes (arrows) over toe.
Fig. 7
Echocardiography showed vegetation (arrow) over the anterior leaflet of mitral valve (white arrow).
Infective endocarditis (IE) is not uncommonly treated in daily emergency department (ED) practice, but can sometimes be life-threatening. The diagnosis of IE may pose a challenge to ED physicians because of its possible vague or atypical presenting symptoms. We present herein a previously healthy 23-year-old woman who visited the hospital after having progressively blurred vision in the prior 3 days. During the medical history inquiry, she mentioned mild and intermittent low grade fevers but no other specific discomfort.
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