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Infective endocarditis initially manifesting as pseudogout

Tim Brotherton1, Chad S Miller1,2

  • 1Department of Medicine, Saint Louis University, St. Louis, Missouri.

Proceedings (Baylor University. Medical Center)
|July 5, 2021
PubMed

Insights

Infective endocarditis and pseudogout can present with joint inflammation. This case highlights their co-occurrence, potentially amplifying the inflammatory response in patients with COVID-19.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Rheumatology

Background:

  • Infective endocarditis (IE) presents diagnostic challenges due to varied clinical signs.
  • Early IE diagnosis is critical to prevent mortality.
  • Both IE and pseudogout activate innate immune pathways, causing joint inflammation.

Observation:

  • A 31-year-old male presented with right ankle pseudogout and COVID-19 infection.
  • Blood cultures revealed Staphylococcus aureus bacteremia.
  • Echocardiography confirmed infective endocarditis.

Findings:

  • The patient had co-occurring pseudogout and infective endocarditis.
  • The combined conditions likely led to an intensified inflammatory response.
  • Shared pathophysiologic pathways may explain the augmented inflammation.

Implications:

  • This case underscores the importance of considering IE in patients with joint inflammation and concurrent infections.
  • Recognizing the interplay between these conditions can improve diagnostic accuracy.
  • Understanding overlapping inflammatory mechanisms may guide future therapeutic strategies.

Keywords:
Acute calcium pyrophosphate crystal arthritisacute CPP crystal arthritisendocarditisimmune complexinfective endocarditispseudogout

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