An infective endocarditis case with skin lesions

Öz

Infective endocarditis is the microbial infection of the endothelial surface of the heart. It is a rare but serious disease and carries a high risk of mortality and morbidity. The clinical findings and symptoms of infective endocarditis are various. High body temperature, sudden and variable cardiac murmur, splenomegaly, Osler nodules by immunocomplex vasculitis, Janeway lesions, Roth spots at funduscopy may be seen. Antibiotic therapy should be initiated quickly, and should be followed closely in terms of need for surgery. In this case report a female patient who had applied to our clinic with skin lesions, high body temperature and aortic valve vegetation diagnosed as infective endocarditis and later healed by successfull aortic valve replacement is presented.

Key Words: Infective endocarditis, aortic valve replacement, skin lesion

Anahtar Kelimeler

• -

Deri lezyonlu enfektif endokardit olgusu

Öz

İnfektif endokardit, kalbin endotelyal yüzeylerinin mikrobiyal infeksiyonudur. Nadir fakat ciddi bir hastalıktır ve yüksek mortalite ve mobidite riski taşır. İnfektif endokardit’ in klinik belirti ve bulguları oldukça zengin ve değişkendir. Yüksek ateş, yeni başlayan veya özellik değiştiren kardiyak üfürüm, splenomegali, immün kompleks vaskülitine bağlı gelişen osler nodülleri, Janeway lezyonları ve göz dibi incelemesinde Roth spot görülebilir. Antibiyotik tedavisi hızlıca başlanılmalı ve cerrahi tedavi gerekliliği açısından yakın takip edilmelidir. Bu yazıda deri bulguları ve yüksek ateş ile kliniğimize başvuran ve aort kapak vejetasyonu tespit edilerek infektif endokardit tanısı konulan ve başarılı aort kapak replasmanı ile kliniği tamamen düzelen bir bayan hasta sunulmuştur.

Anahtar Kelimeler: İnfektif endokardit, aort kapak replasmanı, deri lezyonu

Anahtar Kelimeler

• İnfektif endokardit, aort kapak replasmanı, deri lezyonu

Kaynakça

1. Pereira CA, Rocio SC, Ceolin MF, Lima AP, Borlot F, Pereira RS, et al Clinical and laboratory findings in a series of cases of infective endocarditis. J Pe- diatr (Rio J) 2003;79:423-8.
2. Colen TW, Gunn M, Cook E, Dubinsky T. Radiologic manifestations of extra- cardiac complications of infective endocarditis. Eur Radiol 2008;18: 2433- 45.
3. O’Brien S, Dayer M, Benzimra J, Hardman S, Townsend M. Streptococ- cus pneumoniae endocarditis on replacement aortic valve with panopt- halmitis and pseudoabscess. BMJ Case Reports 2011;doi:10.1136/ bcr.06.2011.4304.
4. Bayer AS, Bolger AF, Taubert KA, Wilson W, Steckelberg J, Karchmer AW, et al Diagnosis and management of infective endocarditis and its complicati- ons. Circulation 1998;98:2936-48.
5. Ergül Y, Yıldız EP, Nişli K, Aydoğan Ü, Dindar A, Aydınlı N at al. Rarely seen embolic events associated with infective endocarditis: case report. J Child.2011;11:138-42.
6. Türkkan D, Yüksel F, Şamdancı E, Ak S. Septic embolsim of central nervous system due to infective endocarditis: An autopsy case. J Inonu University. 2010;17: 387-9.
7. Durack DT, Lukes AS, Bright DK. New criteria for diagnosis of infective en- docarditis: utilization of spesific echocardiographic findings: Duke Endocar- ditis Service. Am J Med 1994;96: 200-9.
8. Fernandez Guerrero ML, Gonzalez Lopez JJ, Goyenechea A, Fraile J, de Gorgolas M. Endocarditis caused by Staphylococcus aureus: A reappraisal of the epidemiologic, clinical, and pathologic manifestations with analy- sis of factors determinig outcome. Medicine ( Baltimore).2009; 88:1-22. doi:10.1097/ MD.0b013e318194da65.

9. Küçükateş E, Gültekin N,Bağdatlı Y. Cases of active infective endocarditis in a university hospital during a 10-year period. J Pak Med Assoc.2013; 63:1163-7.
10. Elbey MA, Akdağ S, Kalkan ME, Kaya MG,Sayın MR, Karapınar H et al A multicenter study on experience of 13 tertiary hospitals in Turkey in patients with infective endocarditis. The Anatolian Journal of Cardiology, 2013;13: 523-7.
11. ESC Kılavuzu. İnfektif endokardit tanı, korunma ve tedavisi kılavuzu. Avrupa Kardiyoloji Derneği. Horstkotte D, Follath F, Gutschik E, Lengyel M, Oto A, Pavie A, Soler-Soler J, Thiene G, von Graevenitz A. 2004. 30-40, 50-5.
12. Pereira CA, Rocio SC, Ceolin MF, Lima AP, Borlot F, Pereira RS, et al Clinical and laboratory findings in a series of cases of infective endocarditis. J Pe- diatr (Rio J) 2003;79:423-8.
13. Colen TW, Gunn M, Cook E, Dubinsky T. Radiologic manifestations of extra- cardiac complications of infective endocarditis. Eur Radiol 2008;18: 2433- 45.
14. O’Brien S, Dayer M, Benzimra J, Hardman S, Townsend M. Streptococ- cus pneumoniae endocarditis on replacement aortic valve with panopt- halmitis and pseudoabscess. BMJ Case Reports 2011;doi:10.1136/ bcr.06.2011.4304.
15. Bayer AS, Bolger AF, Taubert KA, Wilson W, Steckelberg J, Karchmer AW, et al Diagnosis and management of infective endocarditis and its complicati- ons. Circulation 1998;98:2936-48.
16. Ergül Y, Yıldız EP, Nişli K, Aydoğan Ü, Dindar A, Aydınlı N at al. Rarely seen embolic events associated with infective endocarditis: case report. J Child.2011;11:138-42.
17. Türkkan D, Yüksel F, Şamdancı E, Ak S. Septic embolsim of central nervous system due to infective endocarditis: An autopsy case. J Inonu University. 2010;17: 387-9.
18. Durack DT, Lukes AS, Bright DK. New criteria for diagnosis of infective en- docarditis: utilization of spesific echocardiographic findings: Duke Endocar- ditis Service. Am J Med 1994;96: 200-9.
19. Fernandez Guerrero ML, Gonzalez Lopez JJ, Goyenechea A, Fraile J, de Gorgolas M. Endocarditis caused by Staphylococcus aureus: A reappraisal of the epidemiologic, clinical, and pathologic manifestations with analy- sis of factors determinig outcome. Medicine ( Baltimore).2009; 88:1-22. doi:10.1097/ MD.0b013e318194da65.
20. Küçükateş E, Gültekin N,Bağdatlı Y. Cases of active infective endocarditis in a university hospital during a 10-year period. J Pak Med Assoc.2013; 63:1163-7.
21. Elbey MA, Akdağ S, Kalkan ME, Kaya MG,Sayın MR, Karapınar H et al A multicenter study on experience of 13 tertiary hospitals in Turkey in patients with infective endocarditis. The Anatolian Journal of Cardiology, 2013;13: 523-7.
22. ESC Kılavuzu. İnfektif endokardit tanı, korunma ve tedavisi kılavuzu. Avrupa Kardiyoloji Derneği. Horstkotte D, Follath F, Gutschik E, Lengyel M, Oto A, Pavie A, Soler-Soler J, Thiene G, von Graevenitz A. 2004. 30-40, 50-5.