Internal Medicine, University of Louisville, Louisville, Kentucky, USA
Internal Medicine, University of Louisville, Louisville, Kentucky, USA.
BMJ Case Rep. 2021 Jan 25;14(1):e239961. doi: 10.1136/bcr-2020-239961.
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.
感染性心内膜炎与多种临床症状相关,但与多系统血管炎相关的情况很少见报告。鉴别原发性自身免疫性血管炎和感染性病因需要高度警惕,因为错误的治疗可能导致严重的发病率和死亡率。我们报告了一例 71 岁女性患者,其血液培养阴性,近期菌血症正在使用抗生素治疗,表现为皮肤和肾脏白细胞碎裂性血管炎。检查发现她的右心房起搏器导线上有一个赘生物,符合感染性心内膜炎的诊断,适当的抗生素治疗后她的血管炎完全缓解。