I’ve been sick for a very long time with a number of symptoms not visible to most. No doctor has been able to (or been kind enough to) find out what’s wrong with me. I do, however, have one visible symptom and they are splinter hemorrhages.
A while ago, when I first got sick I noticed this splinter under my nail and was puzzled at how it had gotten there. I tried to remove it to no avail so I went to good old google to find some suggestions. It was then that I found out about splinter hemorrhages.
Every time I see a doctor I play dumb, act as if I don’t know what they are, and hope they will know (you won’t get taken seriously if they think you’re a paranoid, internet head case). But every time I present this symptom, they look at it as if its something completely alien to them.
Also, when I did research on splinter hemorrhages all it says is that it is commonly caused by trauma to the nail or endocarditis. I know its not caused by trauma to the nail because I get multiple hemorrhages on multiple nails and I don’t do anything that could cause that kind of trauma to my nails. I also know I don’t have endocarditis as I’ve had a chest X-ray, EKGs, etc due to palpitations I’ve developed.
Now for my question. What could cause splinter hemorrhages other than endocarditis and trauma? I’ve read of vasculitis but I don’t think that’s my issue.
I’m hoping I can get a little insight here. You never know. This one symptom could be the dead give away of what has plagued me for the past 2 years. Thanks guys.
Not a doctor, but if you have a condition that weakens the walls of your blood vessels, even typing can cause fingertip damage if that particular capliiary is getting ready to blow.
Are you vitamin deficient? I know that some vit deficiency can cause weakening of the blood vessel walls…
Splinter hemorrhages that are close to the nail bed tend to be of more significance than those that are at the end of the nail. Likewise, wide ones are more associated with disease than thin ones. By wide, I mean about 1 mm or so (or, phrased differently, not razor thin).
IMNSHO, the ONLY way to r/o endocarditis is by having multiple sets of negative blood cultures (with blood cultures meaning to check if bacteria or other germs are growing in the blood).
If someone’s been feeling sick for a long time, has remained undiagnosed, has splinter hemorrhages, and has not had blood cultures taken, he should get them done. Infectious endocarditis is absolutely notorious for remaining undiagnosed for many months.
If you’re able to, go to a university teaching hospital.
Can endocarditis go undiagnosed for 2 years??? Plus I’m 22. The only thing I can think that might have initiated an endocarditis infection is my nipple piercings or my navel piercing. But neither of them have been infected and I’ve had them both for about 3 years now.
In addition to blood cultures, the evaluation for endocarditis would include a high quality ultrasound (echocardiogram) of the heart. Some of the rarer organisms can be hard to culture. As well, some oddball intracardiac lesions that are not necessarily infections can present with splinter hemorrhages and would be seen on echo.
Endocarditis can be very indolent and not necessarily progressive in a straightline downhill.
Splinter hemorrhages are not well understood and are not specific for endocarditis.
If I had a relative who was chronically unwell and had splinter hemorrhages I would encourage him to take KarlGauss’s advice and present to an academic institution for workup. My boards are in Internal Medicine and Emergency Medicine, and I agree with him that the presentation of infective endocarditis can be tricky. Equally protean can be the manifestations of other similar immune-complex related illnesses.
I emphasized the blood cultures because they’re simple, cheap, and often informative (in fact, if the typical causative organisms are responsible, blood cultures will be positive in more than 90 percent of cases). OTOH, an ECHO is more expensive than a blood culture, and, if one’s truly serious about looking for endocarditis, a so-called “transesophageal ECHO*” would be required (which is invasive and even more costly than the usual screening transthoracic ECHO**).
this type of echocardiogram involves inserting the ultrasound probe right down into the esophagus so as to wind up right beside the heart (inside the body). This increases the accuracy of finding “vegetations” (i.e. bacterial and/or fungal collections).
** this type of echocardiogram involves holding the ultrasound probe against the chest wall. Since its sound waves must traverse the skin, muscle and any underlying tissues, it is, therefore, less able to provide a clear view of things (especially small entities such as vegetations on the heart valves).
Thank you both very much for you very thorough responses. That was one other test I forgot to mention I’d had was and echo. The EKG and X-rays were performed when I went to the emergency room for palpitations that lasted 3 days and got progressively worse. They, of course, said it was anxiety and sent me home with a prescription for xanax. :o/
At the risk of sounding like a wannabe mod, I’ll note that at the SDMB, one bump is usually considered reasonable (if a reasonable amount of time has passed since the OP). However, more than one bump, while not officially prohibited, is certainly frowned upon. I’m a bit surprised that no mod has called you on that.
I’ve made this post this in case you decide to ante up and “join the crew”.
