Infective endocarditis and Sjögren's syndrome diagnosed simultaneously

Area of Science:

• Cardiology
• Infectious Diseases
• Rheumatology

Background:

• Poor oral hygiene and dental infections are potential risk factors for infective endocarditis (IE).
• Sjögren's syndrome (SS) is an autoimmune disorder primarily affecting salivary and lacrimal glands, but can have systemic implications.

Purpose of the Study:

• To report a unique case of infective endocarditis (IE) caused by Granulicatella adiacens in a patient with primary Sjögren's syndrome (SS) and concurrent oral complications.
• To explore the potential association between SS, oral health, and the risk of IE.

Main Methods:

• A case study of a 67-year-old woman presenting with symptoms of fever and fatigue.
• Diagnosis of primary SS using the American-European Consensus Group criteria.
• Transthoracic echocardiography to identify cardiac abnormalities.
• Blood cultures to identify causative microorganisms.
• Diagnosis of IE based on modified Duke's criteria.

Main Results:

• The patient was diagnosed with primary SS and infective endocarditis (IE) caused by Granulicatella adiacens.
• Echocardiography revealed vegetation on the aortic valve.
• The patient had chronic periodontitis, suggesting a link between oral complications of SS and bacteremia.
• Successful treatment involved aortic valve replacement and a 6-week course of ampicillin and gentamicin.

Conclusions:

• Sjögren's syndrome (SS) with oral complications, such as chronic periodontitis, may predispose patients to bacteremia and subsequent infective endocarditis (IE).
• This case suggests a potential, previously unreported association between SS and IE, with SS possibly being an underlying factor.
• Healthcare providers should consider the oral health status of patients with SS when assessing IE risk.