What is a characteristic physical exam finding in infective endocarditis?

Infective endocarditis is characterized by the presence of vegetations on heart valves due to bacterial infection. One distinctive physical exam finding associated with this condition is the presence of Roth spots. Roth spots are retinal hemorrhages with white or pale centers, seen during an ophthalmologic examination. They occur due to embolization of the bacteria or the immune complex associated with the infection, leading to localized damage in the retinal vessels.

The identification of Roth spots in a patient can be an important clue suggesting the diagnosis of infective endocarditis, particularly in those who present with additional systemic signs such as fever or a new heart murmur. This finding underlines the systemic nature of the infection and its ability to cause multiorgan involvement.

In contrast, although an increased heart rate can occur in many febrile illnesses and might be seen in other conditions, it is not specific to infective endocarditis. Elevated blood pressure is also not a typical finding in this scenario. Decreased heart sounds can occur in some forms of heart failure or pericardial effusion but are not characteristic of infective endocarditis itself. Roth spots remain a unique marker that directly relates to the embolic phenomena linked with this infectious process.