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Endocarditis II: Clinical features and Diagnostic Tests01:25

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Isolated Lower Limb Vasculitis Following SARS-CoV-2 Infection: A Case Report.

Alexander Mitropoulos1, Maanasa Bandla1, Joshua H Abasszade1

  • 1Department of General Medicine, Monash Health, Melbourne, AUS.

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|November 15, 2024
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Summary

This case report details a rare instance of isolated vasculitis affecting medium to small vessels following a severe acute respiratory syndrome-coronavirus 2 infection. Prompt treatment with prednisolone and methotrexate led to complete symptom resolution.

Keywords:
covidisolatedlower limbsars-cov-2vasculitis

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Area of Science:

  • Immunology
  • Rheumatology
  • Infectious Diseases

Background:

  • Vasculitis is an autoimmune condition characterized by blood vessel inflammation, often leading to systemic complications.
  • Isolated vasculitis, particularly affecting medium to small vessels, is exceptionally rare.
  • Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection has been linked to various post-infectious complications.

Observation:

  • A 70-year-old male presented with significant weight loss, nausea, and bilateral knee pain three weeks after SARS-CoV-2 infection.
  • Laboratory findings revealed elevated inflammatory markers (CRP, ESR, WBC with neutrophilia).
  • FDG-PET imaging indicated vasculitis in the medium and small vessels of the lower limbs.

Findings:

  • The patient received prednisolone and methotrexate, resulting in complete symptom resolution within three and a half months.
  • Repeat FDG-PET confirmed the resolution of vasculitic changes in the lower limbs.
  • The clinical presentation and continuous SARS-CoV-2 positivity suggest a potential link between the infection and isolated vasculitis.

Implications:

  • This case highlights a unique potential trigger for isolated medium to small vessel vasculitis.
  • It underscores the importance of considering vasculitis in patients with relevant symptoms post-SARS-CoV-2 infection.
  • Further research is warranted to explore the association between SARS-CoV-2 and vasculitis.