Arthritis as a manifestation of infective endocarditis

  • Karyna Uvarova Assistant of Department of Propaedeutics of Internal Medicine and Physical Rehabilitation of V. N. Karazin Kharkiv National University https://orcid.org/0000-0003-3135-0778
Keywords: infective endocarditis, clinical diagnosis, arthritis

Abstract

Introduction. Diagnosis of infective endocarditis is a challenging task for clinicians. The issue of early infective endocarditis detection is topical, since the mortality rate of this pathological condition is high; also, along with the classic symptoms of the disease, its atypical manifestations, so-called "masks" of infective endocarditis, often occur.

Objectives. The purpose of the work is to investigate one of infective endocarditis manifestations in the form of monoarthritis on the clinical case basis.

Materials and methods. The medical history, the laboratory and instrumental findings, Guidelines for the management of infective endocarditis 2015; Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications, AHA 2015 (including update 2016).

Results. The patient, born in 1952, complains of the right foot pain, fever with chills, general weakness. Considers herself ill for 3 weeks. In connection with the right foot pain intensification, the patient was taken to a multidisciplinary hospital by the ambulance team and hospitalized to the therapeutic department. The anamnesis vitae is notable for her undergoing a procedure for curettage of the uterine cavity for an endometrial polyp half a year before the admission. The main diagnosis: Active mitral valve endocarditis due to Streptococcus haemolyticus. Mitral valve regurgitation stage III. Chronic coronary syndrome. Heart failure with preserved ejection fraction (EF 68 %). NYHA class II. Concomitant diagnosis: Mild anemia. Reactive arthritis. Deforming osteoarthrosis of the ankle joint. The treatment included: meronem 1 g 3 times daily intravenously (IV) and linezolidine 600 mg 2 times a day per os during 4 weeks; detoxification, cardiotropic, antiplatelet and anticoagulant therapy; proton pump inhibitors, diuretics, antifungal drugs.

Conclusion. Diagnosis of infective endocarditis is very challenging despite the presence of the specially developed diagnostic criteria. Given the polymorphic clinical manifestations of the disease and multiple organ damage, clinicians should be wary of the presence of infective endocarditis in patients with corresponding risk factors.

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Author Biography

Karyna Uvarova, Assistant of Department of Propaedeutics of Internal Medicine and Physical Rehabilitation of V. N. Karazin Kharkiv National University

Svobody Sq, 4, Kharkiv, Ukraine, 61022

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Published
2020-09-08
How to Cite
Uvarova, K. (2020). Arthritis as a manifestation of infective endocarditis. The Journal of V. N. Karazin Kharkiv National University, Series "Medicine", (39), 111-116. https://doi.org/10.26565/2313-6693-2020-39-13