An Unusual Presentation of Infective Endocarditis

Leukocytoclastic vasculitis is the inflammation of small blood vessels due to leukocyte migration that comprises a wide range of differentials. It can be caused by autoimmune disorders, infections, neoplasms, or certain medications and warrants prompt recognition and therapy for optimal patient outcomes.

Here we present a case of a 37-year-old male who presented with a painful, petechial rash on his torso and extremities. Skin biopsy revealed leukocytoclastic vasculitis, thereby prompting a comprehensive investigation into the underlying etiology leading to the diagnosis of Pseudomonas aeruginosa infective endocarditis.

Pseudomonas aeruginosa is a rare cause of infective endocarditis with a high mortality and morbidity rate. This case highlights the importance of taking a thorough history and physical along with a complete workup of vasculitis as the underlying cause can be life-threatening.