A case series of skin manifestations of infective endocarditis in contemporary era: just another book finding or a useful clinical sign?
Case series
Infective endocarditis
Janeway lesions
Osler’s nodes
Skin
Splinter haemorrhages
Journal
European heart journal. Case reports
ISSN: 2514-2119
Titre abrégé: Eur Heart J Case Rep
Pays: England
ID NLM: 101730741
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
09
01
2021
revised:
22
03
2021
accepted:
18
08
2021
entrez:
24
9
2021
pubmed:
25
9
2021
medline:
25
9
2021
Statut:
epublish
Résumé
Infective endocarditis (IE) is a disease of high morbidity and mortality. Infective endocarditis rarely involves skin manifestations in the contemporary era. The identification of typical skin lesions could be helpful in establishing early diagnosis of IE. We present four cases of IE hospitalized in our institution within a 12-month period. All patients were young and had skin manifestations on initial presentation (petechiae, splinter haemorrhages, Janeway lesions, and Osler's nodes), which led to a high clinical suspicion of IE confirmed by echocardiography and positive blood cultures. All cases had a complicated course. One patient died and the other three had prolonged hospital stay due to variable complications. Clinicians should always assess for skin manifestations in patients with fever especially when suspicion of IE is high. Occurrence of skin lesions in the course of IE may be associated with higher rate of complications and worse prognosis.
Sections du résumé
BACKGROUND
BACKGROUND
Infective endocarditis (IE) is a disease of high morbidity and mortality. Infective endocarditis rarely involves skin manifestations in the contemporary era. The identification of typical skin lesions could be helpful in establishing early diagnosis of IE.
CASE SUMMARY
METHODS
We present four cases of IE hospitalized in our institution within a 12-month period. All patients were young and had skin manifestations on initial presentation (petechiae, splinter haemorrhages, Janeway lesions, and Osler's nodes), which led to a high clinical suspicion of IE confirmed by echocardiography and positive blood cultures. All cases had a complicated course. One patient died and the other three had prolonged hospital stay due to variable complications.
DISCUSSION
CONCLUSIONS
Clinicians should always assess for skin manifestations in patients with fever especially when suspicion of IE is high. Occurrence of skin lesions in the course of IE may be associated with higher rate of complications and worse prognosis.
Identifiants
pubmed: 34557639
doi: 10.1093/ehjcr/ytab345
pii: ytab345
pmc: PMC8453381
doi:
Types de publication
Case Reports
Langues
eng
Pagination
ytab345Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.
Références
Int J Dermatol. 1993 Sep;32(9):673-4
pubmed: 8407097
Am J Med. 2013 Oct;126(10):843-4
pubmed: 24054951
JAMA Dermatol. 2014 May;150(5):494-500
pubmed: 24500311
Clin Infect Dis. 1997 Sep;25(3):713-9
pubmed: 9314466
Circulation. 2005 Jul 5;112(1):69-75
pubmed: 15983252
J Am Acad Dermatol. 1990 Jun;22(6 Pt 1):1088-90
pubmed: 2370335
N Engl J Med. 2001 Nov 1;345(18):1318-30
pubmed: 11794152
Pediatrics. 2003 Aug;112(2):e162-7
pubmed: 12897323
Am J Med. 2008 Feb;121(2):105-6
pubmed: 18261495
Int J Dermatol. 2000 Apr;39(4):290-2
pubmed: 10809980
JAMA Dermatol. 2015 Aug;151(8):907-8
pubmed: 25924060
Arch Intern Med. 2009 Mar 9;169(5):463-73
pubmed: 19273776
Br Med J. 1963 Dec 14;2(5371):1496-8
pubmed: 14063073
BMJ Case Rep. 2019 Oct 14;12(10):
pubmed: 31611230
Eur Heart J. 2011 Aug;32(16):2016-26
pubmed: 19329801
Ann Intern Med. 1976 Oct;85(4):471-3
pubmed: 788582
Eur Heart J. 2015 Nov 21;36(44):3075-3128
pubmed: 26320109