Abstract
Infective endocarditis is a diagnostic challenge since it could manifest as a systemic disease mimicking rheumatologic disorders by immunological mechanisms. We introduced a case of infective endocarditis which was a 62-year-old man who presented with weakness, weight loss, myalgia, arthritis, petechiae, hematuria and proteinuria and was admitted by a rheumatologist for evaluation of possible vasculitis.
Highlights
Infective endocarditis is a life-threatening and serious infection which presents in acute and subacute forms since it has high morbidity and mortality despite major improvements in medical and surgical approaches [1,2,3]
Native valve infective endocarditis remains a diagnostic challenge with nonspecific signs and symptoms owing to extensive use of antibiotics and underlying conditions in old patients [4,5]
The patient was healthy with an unremarkable medical history until six months earlier when he gradually began to feel unwell associated with weakness, loss of appetite and weight loss
Summary
Infective endocarditis is a life-threatening and serious infection which presents in acute and subacute forms since it has high morbidity and mortality despite major improvements in medical and surgical approaches [1,2,3]. His main complaints were weakness, weight loss, arthralgia and skin rashes but no chills and fever His physical examination had revealed almost normal vital signs, paleness, weak systolic murmur, palpable spleen, pedal edema and skin rashes on his legs. His vital signs were as followings; temperature of 37°C, blood pressure of 140/70 mm Hg, PR: 100 beats/min, and RR of 32/min He had orthopnea and elevated jugular venous pressure with fine crackles in both lungs and a 3/6 systolic murmur at apex and generalized edema. Transthoracic echocardiogram and transesophageal echocardiography revealed severe mitral regurgitation with multiple highly mobile masses attached to mitral valve compatible with endocarditis, since one of three blood cultures was positive for S. viridans. In the last follow-up visit (three years later), he still was healthy and on warfarin therapy
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