Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 8, Number 10, October 2017, pages 318-321

Endocarditis due to Multidrug-Resistant Klebsiella pneumoniae-KPC


Figure 1.
Figure 1. Hand Janeway lesions.
Figure 2.
Figure 2. Splinter hemorrhages.
Figure 3.
Figure 3. Foot Janeway lesions.
Figure 4.
Figure 4. Flail posterior leaflet with moderate regurgitation and vegetation 1.6 × 0.6 cm.


Table 1. Duke Criteria
Major criteriaPositive blood culture
Classic echocardiogram findings
Minor criteriaPredisposing factors (poor dentition, IVDA)
Fever (over 38.0 °C)
Vascular phenomena (hemorrhages, embolic)
Immunologic phenomena (glomerulonephritis, Osler’s nodes)


Table 2. Levine Scale for Murmurs
Grade 1Faint, heard only with special effort
Grade 2Faint, but is immediately audible
Grade 3Moderately loud, no thrill
Grade 4Loud murmur, no thrill
Grade 5Extremely loud, audible with one edge of the stethoscope touching the chest wall
Grade 6Extremely loud, heard without a stethoscope