Arthritis as a manifestation of infective endocarditis
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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References
Abdulhak, A., Baddour, L., Erwin, P., Hoen, B., Chu, V., Mensah, G., Tleyjeh, I. (2014). Global and regional burden of infective endocarditis, 1990–2010: a systematic review of the literature. Global Heart, 9(1), 131–143. doi:10.1016/j.mce.2014.01.002.
Kaura, A., Dworakowska, D., Dworakowski, R. (2017). Infective endocarditis-Cinderella in cardiology. Kardiol Pol, 75 (10), 965–74. doi:10.1016/j.mce.2014.01.002.
Watt, G., Lacroix, A., Pachirat, O., Bagget, H., Raoult, D., Fournier, P., Tattevin, P. (2015). Prospective comparison of infective endocarditis in Khon Kaen, Thailand and Rennes, France. The American journal of tropical medicine and hygiene, 92(4), 871–874. doi:10.4269/ajtmh.14-0689.
Greenspon, A., Patel, J., Lau, E., Ochoa, J., Frisch, D., Ho, R. ... Kurtz, S. (2011). 16-year trends in the infection burden for pacemakers and implantable cardioverter-defibrillators in the United States: 1993 to 2008. Journal of the American College of Cardiology, 58(10), 1001–1006. doi:10.1016/j.jacc.2011.04.033.
DeSimone, D., DeSimone, C., Tleyjeh, I., Correa de Sa, D., Anavekar, N., Lahr, B. ... Baddour, L. (2015). Association of mitral valve prolapse with infective endocarditis due to viridans group streptococci. Clinical Infectious Diseases, 61(4), 623–625. doi:10.1093/cid/civ375.
Chen, T., Yeh, Y., Chien, K., Lai, M., Tu, Y. (2018). Risk of infective endocarditis after invasive dental treatments: case-only study. Circulation, 138(4), 356-363. doi:10.1161/CIRCULATIONAHA.117.033131.
Holland, T., Baddour, L., Bayer, A., Hoen, B., Miro, J., Fowler, V. (2016). Infective endocarditis. Nature reviews. Disease primers, 2, 16059. doi:10.1038/nrdp.2016.59.
Le Moing, V., Alla, F., Doco-Lecompte, T., Delahaye, F., Piroth, L., Chirouze, C. ... Vandenesch, F. (2015). Staphylococcus Aureus bloodstream infection and Endocarditis-a prospective cohort study. PloS one, 10(5), e0127385. doi:10.1371/journal.pone.0127385.
Federspiel, J., Stearns, S., Peppercorn, A., Chu, V., Fowler, V. (2012). Increasing US rates of endocarditis with Staphylococcus aureus: 1999-2008. Archives of internal medicine. 172(4), 363–365. doi:10.1001/archinternmed.2011.1027.
Duval, X., Delahaye, F., Alla, F., Tattevin, P., Obadia, J., Le Moing, V. ... Chirouze, C. (23012). Temporal trends in infective endocarditis in the context of prophylaxis guideline modifications: three successive population-based surveys. Journal of the American College of Cardiology, 59(22), 1968–1976. doi:10.1016/j.jacc.2012.02.029.
Pericás, J., Zboromyrska, Y., Cervera, C., Castañeda, X., Almela, M., Garcia-De-La-Maria, C. ... Llopis, J. (2015). Enterococcal endocarditis revisited. Future microbiology, 10(7), 1215–1240. doi:10.2217/fmb.15.46.
Habib, G., Lancellotti, P., Antunes, M., Bongiorni, M., Casalta, J., Del Zotti, F. ... Miro, J. (2015). 2015 ESC guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European Society of Cardiology (ESC) endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). European heart journal, 36(44), 3075–3128. doi:10.1093/eurheartj/ehv319.
Hitzeroth, J., Beckett, N., Ntuli, P. (2016). An approach to a patient with infective endocarditis. SAMJ: South African Medical Journal, 106(2), 145–150. doi:10.7196/SAMJ.2016.v106i2.10327.
Lobzin, Yu. V., Levina, A.S. (2015). Klinicheskie maski infekczionnogo endokardita. Zhurnal infektologii, 7(2), 14–20. [Russian]. doi:10.22625/2072-6732-2015-7-2-14-20.
Lieber, S., Shmerling. R., Moore, A., Fowler, M., Nasrullah, K., Paz, Z. (2016). Infective Endocarditis with Septic Arthritis: A Single-Center Experience [abstract]. Arthritis Rheumatol, 68 (suppl 10). Retrieved from https://acrabstracts.org/abstract/infective-endocarditis-with-septic-arthritis-a-single-center-experience/. Accessed February 28, 2020.
Soor, P., Sharma, N., Rao, C. (2017). Multifocal septic arthritis secondary to infective endocarditis: a rare case report. Journal of orthopaedic case reports, 7(1), 65. doi:10.13107/jocr.2250-0685.692.
Baddour, L., Wilson, W., Bayer, A, Fowler, V., Tleyjeh, I., Rybak, M. ... Bolger, A. (2015). Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation, 132(15), 1435-1486. doi:10.1161/CIR.0000000000000296
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