Bacterial Endocarditis
One of the conditions that can cause splinter hemorrhages is bacterial endocarditis. It is an infection of the heart that results in inflammation of the inner layer of the heart wall and valves. As a result, blood clots and vegetation can form at these damaged sites. Splinter hemorrhage occurs when blood leaks out of these blood clots and vegetation into the space between layers of the heart wall.
Splinter hemorrhages are most frequently caused by endocarditis in patients with a history of rheumatic fever that develops after a bout with a streptococcal infection such as strep throat. When left untreated, rheumatic fever can damage heart valves through autoimmune tissue damage, which may result in endocarditis and splinter hemorrhages later in life. However, splinter hemorrhages are an uncommon complication of endocarditis, even among those who have had rheumatic fever.
