The Reply

Abstract

We thank Dr Jolobe for his insightful letter concerning our article on red spots on the soft palate in infective endocarditis.1Kano Y Harada Y Red spots on soft palate: an atypical peripheral sign of infective endocarditis.Am J Med. 2023; ([online ahead of print]) (Jan 14; S0002-9343(23)00032-3doi.org/)https://doi.org/10.1016/j.amjmed2022.12.021Crossref Google Scholar As Dr Jolobe has pointed out, Ramsey et al2Ramsey RG Gunnar RM Tobin Jr., JR Endocarditis in the drug addict.Am J Cardiol. 1970; 25: 608-618Abstract Full Text PDF PubMed Google Scholar and Hart and Silverthorne3Hart AP Silverthorne LN A case of acute bacterial endocarditis.Can Med Assoc J. 1929; 21: 305-307Google Scholar have reported cases of infective endocarditis involving “petechiae on the soft palate” and “white-topped embolic haemorrhages,” although they included no photographs or detailed descriptions of the size or clinical course of the lesions. While we are unaware of whether these lesions were identical to those in our case, we hope to see further reports in the future focusing on the oral findings of infective endocarditis. Thanks to the evidence to which Dr Jolobe has referred us, we are more confident that the lesions we observed were a physical finding associated with infective endocarditis, and are also interested in the possibility of their association with Roth spots. However, we did not assess for fundoscopic findings in the present case.