Bacterial Endocarditis Presenting as Leukocytoclastic Vasculitis

Subacute bacterial endocarditis can have many different presentations; in rare instances, it can present as leukocytoclastic vasculitis owing to the effect of circulating immune complexes and micro-emboli on the vascular endothelium. A high index of suspicion needs to be maintained to differentiate between infectious vs noninfectious autoimmune vasculitides, keeping in mind that missing a diagnosis can have fatal results. In this case report, we introduce a young female patient who initially presented with a picture of idiopathic autoimmune cutaneous vasculitis delaying the diagnosis of an underlying infective endocarditis with aortic valve involvement.