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Related Experiment Video

Updated: Apr 30, 2026

Clinical Examination Protocol to Detect Atypical and Classical Scrapie in Sheep
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A forgotten clinical sign making a comeback.

K H Chiam1, C T A Hing2, L L Low2

  • 1Clinical Specialist, Infectious Disease, Internal Medicine, Hospital Sultanah Bahiyah Alor Setar, KM 6, Jalan Langgar, Alor Setar, Kedah Darul Aman 05460, Malaysia. symeon_chiam@yahoo.co.uk.

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Summary

This case study highlights Staphylococcus aureus infective endocarditis, a serious heart valve infection. Early diagnosis and prompt antibiotic treatment are crucial for patient recovery and preventing severe outcomes.

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Dermatology

Background:

  • Infective endocarditis (IE) is a serious infection of the heart valves, often associated with significant morbidity and mortality.
  • Staphylococcus aureus is a common causative pathogen in IE, presenting diagnostic and therapeutic challenges.
  • Rare cutaneous manifestations, such as Osler Nodes and Janeway Lesions, can be indicative of IE.

Purpose of the Study:

  • To report a case of Staphylococcus aureus infective endocarditis with unusual cutaneous findings.
  • To emphasize the importance of clinical acumen in diagnosing IE, especially in the absence of typical risk factors.
  • To illustrate the successful management and recovery from Staphylococcus aureus IE.

Main Methods:

  • Clinical presentation review, including fever and cutaneous signs.
  • Echocardiography for vegetation detection on heart valves.
  • Microbiological assessment to identify Staphylococcus aureus.
  • Treatment with intravenous antibiotics (cloxacillin and gentamicin).

Main Results:

  • The patient presented with fever and characteristic Osler Nodes and Janeway Lesions.
  • Echocardiography confirmed vegetation on the anterior mitral valve leaflet.
  • Staphylococcus aureus was identified as the causative agent.
  • The patient responded well to a 28-day course of intravenous cloxacillin and a 5-day course of gentamicin.

Conclusions:

  • Staphylococcus aureus infective endocarditis requires high clinical suspicion, even without clear risk factors.
  • Prompt diagnosis through echocardiography and appropriate antibiotic therapy are essential for favorable outcomes.
  • Integrated management involving infectious disease and cardiology specialists is key in treating IE.