Blood culture‐negative infective endocarditis presenting with atypical dermatologic manifestation: A rare case report and review of the literature
Abstract Infective endocarditis (IE) rarely presents with cutaneous manifestations due to earlier diagnosis and treatment. We present a case of middle‐aged male patient presenting with an erythematous papular rash in the upper extremities and left knee, further progressing into painful ulcers with c...
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| Format: | Article |
| Language: | English |
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Wiley
2023-06-01
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| Series: | Clinical Case Reports |
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| Online Access: | https://doi.org/10.1002/ccr3.7027 |
| _version_ | 1797791776290897920 |
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| author | Maedeh Najafizadeh Fatemeh Dashti Hamed Pahlevani Farzad Kamalizad Seyed Mohammad Ali Mirazimi |
| author_facet | Maedeh Najafizadeh Fatemeh Dashti Hamed Pahlevani Farzad Kamalizad Seyed Mohammad Ali Mirazimi |
| author_sort | Maedeh Najafizadeh |
| collection | DOAJ |
| description | Abstract Infective endocarditis (IE) rarely presents with cutaneous manifestations due to earlier diagnosis and treatment. We present a case of middle‐aged male patient presenting with an erythematous papular rash in the upper extremities and left knee, further progressing into painful ulcers with crusted and necrotic center in the arms and fingers. These cutaneous lesions were further followed by shaking chills and fever, which brought the patient to our hospital. Laboratory evaluation revealed elevated ESR (erythrocyte sedimentation rate) and C‐reactive protein. Blood cultures taken were negative. Biopsy of the skin lesions were consistent with cutaneous leukocytoclastic vasculitis, and the gram smear revealed gram‐positive cocci. The patient developed dyspnea and chest pain, which raised suspicion for IE. TEE (transesophageal echocardiography) demonstrated mild LV diastolic dysfunction, 1+ tricuspid valve regurgitation, mild mitral regurgitation, and vegetation‐like lesions on the surface of mitral valve leaflets, consequently IE was confirmed. In conclusion, clinicians must look carefully for skin manifestations in cases with high likelihood of IE, even when other typical symptoms are absent. |
| first_indexed | 2024-03-13T02:23:35Z |
| format | Article |
| id | doaj.art-f2aaf1d678c641868547939fb95d04f5 |
| institution | Directory Open Access Journal |
| issn | 2050-0904 |
| language | English |
| last_indexed | 2024-03-13T02:23:35Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj.art-f2aaf1d678c641868547939fb95d04f52023-06-30T07:34:07ZengWileyClinical Case Reports2050-09042023-06-01116n/an/a10.1002/ccr3.7027Blood culture‐negative infective endocarditis presenting with atypical dermatologic manifestation: A rare case report and review of the literatureMaedeh Najafizadeh0Fatemeh Dashti1Hamed Pahlevani2Farzad Kamalizad3Seyed Mohammad Ali Mirazimi4Department of Infectious Diseases, Assistant Professor of Infectious Diseases, Kashan School of Medicine Kashan University of Medical Sciences Kashan IranDepartment of Infectious Diseases, Kashan School of Medicine Kashan university of medical sciences Kashan IranDepartment of Anesthesiology, Kashan School of Medicine Kashan University of Medical Sciences Kashan IranDepartment of Infectious Diseases, Kashan School of Medicine Kashan university of medical sciences Kashan IranDepartment of Infectious Diseases, Kashan School of Medicine Kashan university of medical sciences Kashan IranAbstract Infective endocarditis (IE) rarely presents with cutaneous manifestations due to earlier diagnosis and treatment. We present a case of middle‐aged male patient presenting with an erythematous papular rash in the upper extremities and left knee, further progressing into painful ulcers with crusted and necrotic center in the arms and fingers. These cutaneous lesions were further followed by shaking chills and fever, which brought the patient to our hospital. Laboratory evaluation revealed elevated ESR (erythrocyte sedimentation rate) and C‐reactive protein. Blood cultures taken were negative. Biopsy of the skin lesions were consistent with cutaneous leukocytoclastic vasculitis, and the gram smear revealed gram‐positive cocci. The patient developed dyspnea and chest pain, which raised suspicion for IE. TEE (transesophageal echocardiography) demonstrated mild LV diastolic dysfunction, 1+ tricuspid valve regurgitation, mild mitral regurgitation, and vegetation‐like lesions on the surface of mitral valve leaflets, consequently IE was confirmed. In conclusion, clinicians must look carefully for skin manifestations in cases with high likelihood of IE, even when other typical symptoms are absent.https://doi.org/10.1002/ccr3.7027cutaneous leukocytoclastic vasculitisinfective endocarditisPCIskin |
| spellingShingle | Maedeh Najafizadeh Fatemeh Dashti Hamed Pahlevani Farzad Kamalizad Seyed Mohammad Ali Mirazimi Blood culture‐negative infective endocarditis presenting with atypical dermatologic manifestation: A rare case report and review of the literature Clinical Case Reports cutaneous leukocytoclastic vasculitis infective endocarditis PCI skin |
| title | Blood culture‐negative infective endocarditis presenting with atypical dermatologic manifestation: A rare case report and review of the literature |
| title_full | Blood culture‐negative infective endocarditis presenting with atypical dermatologic manifestation: A rare case report and review of the literature |
| title_fullStr | Blood culture‐negative infective endocarditis presenting with atypical dermatologic manifestation: A rare case report and review of the literature |
| title_full_unstemmed | Blood culture‐negative infective endocarditis presenting with atypical dermatologic manifestation: A rare case report and review of the literature |
| title_short | Blood culture‐negative infective endocarditis presenting with atypical dermatologic manifestation: A rare case report and review of the literature |
| title_sort | blood culture negative infective endocarditis presenting with atypical dermatologic manifestation a rare case report and review of the literature |
| topic | cutaneous leukocytoclastic vasculitis infective endocarditis PCI skin |
| url | https://doi.org/10.1002/ccr3.7027 |
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