How are Lambl's excrescences differentiated from infectious endocarditis?

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Differential Diagnosis for Lambl's Excresences vs. Endocarditis

  • Single Most Likely Diagnosis

    • Lambl's excresences: These are small, fibrotic, and usually benign lesions found on the edges of valve cusps, often associated with aging or valve trauma. They are differentiated from endocarditis by their characteristic location, size, and lack of inflammatory response.
  • Other Likely Diagnoses

    • Valve struts or suture material: These can be mistaken for Lambl's excresences or endocarditis on imaging, but are usually distinguishable by their location and association with valve replacement or repair.
    • Benign cardiac tumors (e.g., papillary fib cysts): These can mimic endocarditis or Lambl's excresences, but tend to have distinct imaging characteristics and are often found in different locations.
    • Cardiac catheterization-related trauma: This can cause small lesions on the valve or endocardium that may be mistaken for Lambl's excresences or endocarditis.
  • Do Not Miss Diagnoses

    • Infective endocarditis: This is a life-threatening condition that requires prompt diagnosis and treatment. It can present with similar imaging findings to Lambl's excresences, but is usually associated with systemic symptoms, positive blood cultures, and more extensive valve damage.
    • Non-bacterial thrombotic endocarditis (NBTE): This condition can mimic infective endocarditis, but is often associated with hypercoagulable states, cancer, or other systemic diseases.
    • Antiphospholipid syndrome: This autoimmune disorder can cause valve lesions that resemble endocarditis or Lambl's excresences, but is often associated with other systemic symptoms and laboratory findings.
  • Rare Diagnoses

    • Cardiac amyloidosis: This condition can cause valve thickening and lesions that may be mistaken for endocarditis or Lambl's excresences, but is usually associated with other systemic symptoms and characteristic imaging findings.
    • Cardiac sarcoidosis: This condition can cause granulomatous lesions on the valves or endocardium that may mimic endocarditis or Lambl's excresences, but is often associated with other systemic symptoms and laboratory findings.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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