Infections due to Bacteroides sp and mixed infections are rare among the elderly. Uremia is associated with an increased incidence of culture-negative endocarditis. The hemodynamic clinical picture depends on how rapidly valvular regurgitation develops and how severe it is. Symptoms and Signs Clinical manifestations are diverse and may involve almost any organ system. Symptoms and signs usually occur within 2 weeks of the bacteremia.
Fever is the most common sign.
Anorexia, fatigue, confusion, back pain, weight loss, and night sweats are also common. Signs of heart failure may also be present. Petechiae are the most common, occurring in crops on the conjunctivae, palate, buccal mucosa, extremities, and skin above the clavicles. Other clinical manifestations may result from thromboemboli. Emboli to the spleen may cause left upper quadrant abdominal pain radiating to the shoulder, a splenic friction rub, or signs of a left pleural effusion.