Which physical findings suggest enterococcal infection?

Updated: Jun 10, 2021
  • Author: Susan L Fraser, MD; Chief Editor: John L Brusch, MD, FACP  more...
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Answer

Physical examination findings in patients with enterococcal infections vary widely and depend on the associated infectious syndrome; therefore, direct the examination according to the patient's symptoms and laboratory findings.

Evaluate the patient for suprapubic or flank tenderness if laboratory findings are consistent with enterococcal UTI.

If the patient has enterococcal bacteremia, carefully evaluate the patient for signs consistent with endocarditis, which include the following:

  • Fever

  • Peripheral stigmata (Janeway lesions, Osler nodes, Roth spots, petechiae, or splinter hemorrhages) 

  • New heart murmur (usually a regurgitant murmur)

Examine the abdomen carefully for signs of organ tenderness, for peritoneal signs of peritonitis, and for ascites.

Examine prosthetic devices and the local skin (eg, orthopedic, cardiac, catheter insertion sites) for signs of infection, including erythema, swelling, tenderness, and/or warmth.


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