20 Symptoms of Endocarditis to Look Out For

11. Petechiae

Petechiae—tiny red or purple dots on the skin—are a subtle yet significant sign of endocarditis. These pinpoint hemorrhages result from broken capillaries and commonly appear on the chest, lower legs, mucous membranes, or under the fingernails (splinter hemorrhages). They indicate small blood vessel damage often caused by circulating immune complexes or emboli. While petechiae can occur in various conditions, their presence in combination with fever, fatigue, or a heart murmur should raise red flags. Many physicians overlook them because they are painless and easy to miss. But in the context of endocarditis, these specks may be the body’s first visible SOS.

12. Osler’s Nodes

Osler’s nodes are painful, red or purple bumps that typically form on the fingers and toes of patients with subacute bacterial endocarditis. These tender nodules arise from immune complex deposition and inflammation within the small vessels of the skin. Though rare, their appearance is diagnostically valuable. Unlike petechiae or splinter hemorrhages, Osler’s nodes are painful to touch and often come and go within hours or days. Their presence points to an ongoing immune battle in the bloodstream and strongly suggests underlying infective endocarditis—particularly in patients with known risk factors like prosthetic valves or IV drug use.