Unusual presentation of infective endocarditis in ICU. Issue 6 (16th June 2021)

• Record Type: Journal Article
• Authors: Lincoln, Marc; Holmes, Zachary; Robinson, Alexander; De Keulenaer, Bart
• Is Part Of: BMJ case reports. Volume 14:Issue 6(2021)
• Publication Date: 2021-06-16
• Subjects: valvar diseases -- adult intensive care -- radiology; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2020-239811
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Bacterial endocarditis remains a challenging condition to manage owing to its variety of different presentations. This report describes a 55-year-old woman with endocarditis who presented confused with shoulder and back pain. Initial diagnosis was made difficult by a negative echocardiogram but aided by striking peripheral stigmata. She was treated for infective endocarditis as she met all five Duke's minor criteria for infective endocarditis. Gallium scan was a useful investigation in identifying lumbar spine and acromioclavicular joint septic foci. This case highlights the challenges of diagnosing endocarditis. It also describes how gallium scans can be useful in identifying occult septic emboli in these patients.