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Case report: livedo reticularis in endocarditis

H Bishop, S C Nelson, W D Ravreby

    The American Journal of the Medical Sciences
    |November 1, 1981
    PubMed
    Summary
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    Peripheral skin signs like petechiae and Osler's nodes can indicate bacterial endocarditis. A unique livedo reticularis rash, linked to immune complex vasculitis, is a newly identified sign of this serious infection.

    Area of Science:

    • Infectious Diseases
    • Dermatology
    • Immunology

    Background:

    • Bacterial endocarditis presents with diverse peripheral manifestations that aid in diagnosis.
    • Common cutaneous signs include petechiae, splinter hemorrhages, and Osler's nodes, often linked to vasculitis or emboli.

    Observation:

    • A patient with Peptostreptococcus intermedius endocarditis initially presented with an asymmetric livedo reticularis rash.
    • This specific rash has not been previously described as a sign of endocarditis.

    Findings:

    • Skin biopsy immunofluorescence suggests the livedo reticularis rash may represent an immune complex vasculitic syndrome.
    • This finding links a novel dermatological sign to the underlying infectious and inflammatory processes of endocarditis.

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    Implications:

    • The identification of livedo reticularis as a potential sign expands the diagnostic repertoire for bacterial endocarditis.
    • This discovery may improve early detection and management of endocarditis, particularly when other signs are absent.