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Infectious Endocarditis Accompanied by Leukocytoclastic Vasculitis
Joshua Lunsford1, Prajwol Pant2,3, Patrick S Rush4,5
1Internal Medicine, Edward Via College of Osteopathic Medicine, Blacksburg, USA.
Cureus
|June 25, 2024
Summary
Bacterial endocarditis can rarely manifest as cutaneous vasculitis, presenting as a purpuric rash. Recognizing this infection is crucial to avoid harmful immunosuppressive treatments for vasculitis.
Area of Science:
- Infectious Diseases
- Dermatology
- Pathology
Background:
- Bacterial endocarditis is a serious infection with diverse clinical presentations.
- Cutaneous vasculitis, particularly leukocytoclastic vasculitis (LCV), is an uncommon manifestation of endocarditis.
- Misdiagnosis can lead to inappropriate immunosuppressive therapy.
Observation:
- A 53-year-old male presented with palpable purpura on his lower extremities.
- The patient had undiagnosed bacterial endocarditis.
- Skin biopsy revealed histopathologic and immunofluorescence findings consistent with LCV.
Findings:
- The case demonstrates a rare presentation of bacterial endocarditis as leukocytoclastic vasculitis.
- Skin biopsy confirmed LCV, linking the cutaneous manifestation to the underlying infection.
- This highlights the importance of considering infectious causes in vasculitis.
Implications:
- Early recognition of endocarditis as a cause of vasculitis is critical.
- Prompt antibiotic treatment for endocarditis can resolve the vasculitis.
- Avoidance of immunosuppressants prevents potentially severe adverse outcomes in patients with infectious endocarditis.
