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Related Experiment Videos

Infective endocarditis presenting as polyarthritis

M Rambaldi1, L Ambrosone, S Migliaresi

  • 1Institute of Clinical Medicine-Rheumatology, Second University of Naples, Napoli, Italy.

Clinical Rheumatology
|January 16, 1999
PubMed
Summary
This summary is machine-generated.

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A patient presented with joint pain preceding infective endocarditis symptoms. Blood cultures eventually identified gentamicin-resistant Enterococcus faecalis, a key finding in diagnosing this rare presentation.

Area of Science:

  • Infectious Diseases
  • Rheumatology
  • Cardiology

Background:

  • Infective endocarditis (IE) typically presents with fever and signs of systemic infection.
  • Arthralgias and arthritis can be early, albeit uncommon, manifestations of IE.
  • Distinguishing IE from other causes of febrile polyarthritis is clinically challenging.

Observation:

  • A patient developed migratory arthralgias and arthritis one month prior to fever and other signs suggestive of infective endocarditis.
  • The patient subsequently presented with febrile polyarthritis and splenomegaly.
  • Two-dimensional echocardiography did not reveal vegetations, initially ruling out endocardial involvement.

Findings:

  • Initial blood cultures were negative.
  • Subsequent blood cultures yielded a high level of gentamicin-resistant Enterococcus faecalis.

Related Experiment Videos

  • This microbiological finding was crucial despite the absence of echocardiographic evidence of endocarditis.

    • Implications:

    • This case highlights the importance of considering infective endocarditis in patients with unexplained arthralgias and fever, even without typical cardiac findings.
    • The identification of gentamicin-resistant Enterococcus faecalis underscores the need for tailored antibiotic therapy in suspected IE.
    • This presentation expands the spectrum of clinical manifestations associated with infective endocarditis.