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Subacute bacterial endocarditis presenting with necrotic skin lesions
International Journal of Dermatology
|June 1, 1983
Summary
Subacute bacterial endocarditis typically presents with classic skin lesions. This case highlights rare bullous necrotic lesions as the sole cutaneous manifestation, confirmed by vessel occlusion and bacterial presence.
Area of Science:
- Infectious Diseases
- Dermatology
- Pathology
Background:
- Subacute bacterial endocarditis (SBE) is a serious infection affecting heart valves.
- Classic cutaneous findings of SBE include petechiae, splinter hemorrhages, Osler's nodes, and Janeway lesions.
Observation:
- A patient with SBE presented with unusual skin findings.
- The only cutaneous manifestations were bullous necrotic lesions on the lower extremities.
Findings:
- Histopathological examination revealed occlusion of superficial vessels by acidophilic material.
- Coccal bacteria were identified within the occluded vessels.
- Immunofluorescence studies demonstrated immunoglobulin M (IgM) and complement component 3 (C3) deposition in the vessel walls.
Implications:
- This case expands the spectrum of recognized cutaneous manifestations of SBE.
- Recognizing atypical skin lesions is crucial for early diagnosis and treatment of SBE.
- The findings support an immune complex-mediated vasculitis in SBE-related skin lesions.