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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
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Experience:  Cardiology Expert
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Infective endocarditis fear. Phil. My case started back in

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Infective endocarditis fear.
Hi Doctor Phil.
My case started back in mid-February this year, when I did a tooth implant. The dentist asked me to take amoxicillin after the surgery for 7 days and I did it.
2 or 3 days after finished the amoxicillin course, I started having a kind of flu (just had fever for a couple of hours in the second day of symptoms) and malayse and coughfor 10 days. Something called my attention regarding my heart beats. I started felling palpitations and also some rapid heart beats (around 100 bpm).
Visited my cardiologist in March, when he ordered a stress test, blood work and a 24hours holter. Everything came back fine, except the holter which showed 1000 isolated pvc's.
Then I got scared to death, by trying to find a relationship between the dental procedure and pvc's. I have done ecg's in the past 5 years (once a year) and none of them showed pvc's before.
The doctor told me that I was fine and it has nothing to do with endocarditis. He mentioned that first I had almost zero risk and second if I was with this disease, I would be felling very ill.
I was ok with his answer, until July when I felt some pain in my left hand thumb and my digital was purple. I couldn't relate it to any injury.
Then by the end of July (15 days after the thumb incident) I developed low grade fever for 3 days. The doctor found out that I had tonsillitis and gave amoxicillin but after 3 days the low grade fever went (99,5 F) came back and he changed to the augmentin drug.
Fever was gone after 2 days. I finished the augmentin 2 weeks ago, but the day it happened I started feeling joint pains, muscle aches and dry cough.
These symptoms started to improve yesterday (12 days after the augmentin course). But I'm still having the pains and dry cough (sometimes I feel a little weak - although I can perform my daily activities.
Is there any chance of it be sub acute endocarditis?

Hi, this is Dr Phil, here to assist you. I am Board Certified with over 10 years of experience. I will respond with my answer shortly. Thank you.

What symptoms make you think IE? subacute?

Customer: replied 2 months ago.
First the infection (flu like) after the dental implant pricedure (11 days after the procedure).
Second because I started having the isolated pvc's and had palpitations (have been dealing with this up to now).
Then because I thought that the thing in my thumb eould would be an osler node.
Third because I had this tonsillitis and had to use two antibiotics (first amoxicillin and them augmentin)
After finished the augmentin course I started having dry cough, joint paints and muscle aches.
Customer: replied 2 months ago.
I read many cases describing that subacute endocarditis can take several months to develop its symptoms.

No, this is not IE.

AFter this many months you would have severe symptoms

SOB, DOE, swelling in your legs

I think this is all coincidence

let me know if you have other questions.

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Customer: replied 2 months ago.
Thank you doctor.
The SOB would be something that I would feel incapable to make my daily routine?
I'm asking this because the dry cough had generated a sensation of SOB (but only moderated).
Customer: replied 2 months ago.
As last question. Does the picture I sent looks like an osler node?

Yes, you would be exhausted with normal activities

Yes, it does look like an osler node

but it could be hand foot and mouth too

that is going around

I have an idea. Get a sed rate blood test done. If it is normal, its not IE

Customer: replied 2 months ago.
you think it still have a chance to be IE?

Very very unlikely

Customer: replied 2 months ago.
Sorry, but since the answer has changed a bit, I have another question. Considering the sequence of things, does it make sense to have an osler node and nothing else and then 15 days after that, developed the fever?

No that doesn't make sense

Plus, osler nodes typically come in bunches

Customer: replied 2 months ago.
Ok, so I do not understand why you first affirmed that it couldn't be IE and them suggest me to do another test to confirm it.

I suggested that to put your mind at ease

Customer: replied 2 months ago.
Sorry but I became very confused doctor.
Customer: replied 2 months ago.
Now do you still suggest me to proceed with the test?

I'm sorry

I didn't mean to confuse you

I'm quite sure this is not IE

but a negative sed rate would be 100%

I wouldn't order it on my own patient

Customer: replied 2 months ago.
Ok, I understand. Than you

welcome :)

let me know if you have other questions.

if done for now, please leave a 5 star rating above the chat box so I can get credit for helping you today

we only get credit for helping clients after positive feedback

you can always reach me with "a question for Dr. Phil" in the medicine, cardiology or pharmacy categories if you have any other questions

here is my website if you need to reach me again:

http://www.justanswer.com/medical/expert-irondoc/

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