Which of the following is not a physical exam finding of infective endocarditis?

Infective endocarditis is characterized by a variety of signs and symptoms resulting from the infection of the heart valves or the endocardium. Common physical findings include Roth spots, Osler nodes, and Janeway lesions, which are all pathological manifestations associated with the condition.

Roth spots are retinal hemorrhages with white centers that can be observed during an eye examination. They are a classic finding in infective endocarditis, indicating systemic embolization from the heart valves.

Osler nodes are painful, raised lesions typically found on the fingers or toes that result from immune complex deposition. They are also indicative of a recent infection.

Janeway lesions are non-painful, flat lesions found on the palms and soles, associated with septic emboli that occur during bacteremia. These findings can point to the presence of infective endocarditis.

In contrast, a palpable thrill, while indicative of significant turbulence in blood flow and possibly associated with other cardiovascular conditions, is not specifically considered a hallmark of infective endocarditis. A thrill is often felt in the presence of significant valvular heart disease or aorto-cardiac fistulas but lacks the direct association with infectious processes or systemic manifestations seen with Roth spots, Osler nodes, and