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Abstract
Infective endocarditis is associated with a variety of clinical signs, but its association with multisystem vasculitis is rarely reported. A high index of suspicion is necessary to differentiate a primary autoimmune vasculitis from an infectious cause as the wrong treatment can lead to significant morbidity and mortality. We present a 71-year-old female patient with negative blood cultures, on antibiotics for recent bacteraemia, who presented with cutaneous and renal leucocytoclastic vasculitis. Workup revealed a vegetation adjacent to her right atrial pacemaker lead consistent with infective endocarditis and her vasculitis completely resolved with appropriate antibiotics.
- cardiovascular medicine
- infectious diseases
- immunology
- dermatology
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Footnotes
Contributors The authors have no conflicts of interest to disclose. JS is the corresponding author and takes responsibility for the accuracy of the data presented. JS wrote the hospital course and differential diagnoses sections. JS and IP researched the literature and wrote the discussion section. MT interpreted the pathology, created the images, and edited the manuscript prior to the final draft. RC was the attending physician on service for this patient, oversaw all work, and contributed directly to the description of clinical reasoning and conclusions drawn. RC is the attending physician of record and also takes responsibility for the accuracy of the data presented. JS, IP, MT and RC have seen and accepted the manuscript in its final form.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.