Case report of culture-negative endocarditis in lupus nephritis.
| Autor: | Khandait H; Trinitas Regional Medical Center, RWJ Barnabas Health, 225 Williamson St, Elizabeth 07202, NJ, USA., Ong CK; Department of Cardiology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK., Javaid A; Department of Cardiology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK., Sandhu R; Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK. |
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| Jazyk: | angličtina |
| Zdroj: | European heart journal. Case reports [Eur Heart J Case Rep] 2023 Jul 07; Vol. 7 (7), pp. ytad290. Date of Electronic Publication: 2023 Jul 07 (Print Publication: 2023). |
| DOI: | 10.1093/ehjcr/ytad290 |
| Abstrakt: | Background: Cardiovascular involvement is frequent in systemic lupus erythematosus (SLE). Valvular abnormalities are increasingly being recognized with the advent of echocardiography. Case Summary: We present a case of a 46-year-old lady who presented to the emergency department with upper limb ischaemia. On examination, she had poor dentition and a short systolic murmur on auscultation. A blood workup revealed a diagnosis of SLE. Further investigations showed vegetations on the mitral valve. Initially, an infective endocarditis (IE) diagnosis was made, which was treated with antibiotics. High-dose steroids and immunosuppressants were initiated due to her clinical deterioration and biopsy-proven lupus nephritis. She improved clinically before being discharged home. Discussion: It can be difficult to distinguish between IE and Libman-Sacks endocarditis (LSE), especially in the setting of risk factors for both. Antibiotics and immunosuppressants might be started simultaneously in these cases. A multidisciplinary team is required to manage challenging cases of culture-negative endocarditis. Procalcitonin may have a role in differentiating bacterial endocarditis and LSE. Competing Interests: Conflict of interest: None declared. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.) |
| Databáze: | MEDLINE |
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