Cutaneous vasculitis: a presentation with endocarditis to keep in mind

Tous‐Romero, Fátima; Delgado-Márquez, Ana María; Gargallo-Moneva, Vanessa; Zarco‐Olivo, Carlos

doi:10.1590/abd1806-4841.20176317

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…An autopsy was performed and showed bacterial vegetation attached to the aortic valve. On the other hand, treatment of the endocarditis with appropriate antibiotics usually leads to resolution of the vasculitis [8][9][10][11][12]. Unfortunately, our patient's case was complicated by significant comorbidities ultimately leading to his death, which prevented us from evaluating the resolution of his LCV with treatment of the bacterial endocarditis.…”

Section: Discussionmentioning

confidence: 87%

“…Out of those assessed, 27 were found to have a systemic bacterial infection, and six of those were diagnosed with infectious endocarditis. Various cases have described patients initially presenting with lower extremity purpuric rash and eventually being diagnosed with bacterial endocarditis [8][9][10][11][12]. Additionally, endocarditis has been shown to mimic other vasculitis-causing conditions such as HSP, ANCA-vasculitis, and cryoglobulinemia [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

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Infectious Endocarditis Accompanied by Leukocytoclastic Vasculitis

Lunsford,

Pant,

Rush

2024

Cureus

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Bacterial endocarditis is a rare infection that can present with variable clinical manifestations. Rarely, it can present as cutaneous vasculitis characterized by a purpuric rash mimicking immune-mediated vasculitis. There have been a few case reports of leukocytoclastic vasculitis (LCV) due to infectious endocarditis. It is important to recognize endocarditis as a potential cause of vasculitis because treatment with immunosuppressive agents can have devastating consequences. We report a case of a 53-year-old male with endocarditis who developed a palpable purpura of the bilateral lower extremities. A skin biopsy was performed, and histopathologic and immunofluorescence studies demonstrated LCV.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Infectious Endocarditis Accompanied by Leukocytoclastic Vasculitis

Lunsford,

Pant,

Rush

2024

Cureus

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“…Previously re- ported cases of IgAV and IE are shown in Table II. [13][14][15][16][17][18][19] Streptococcus strains were identified as IE causative agents in four out of the seven cases, whereas there are currently no reports of IgAV and IE linked to S. pseudoporcinus infection. Although preceding respiratory symptoms were not apparent in the presented case, physicians should be aware that S. pseudoporcinus may be a pathogen that causes IgAV and IE concomitantly.…”

Section: Discussionmentioning

confidence: 99%

IgA Vasculitis Triggered by Infective Endocarditis of Pulmonary Artery with Congenitally Corrected Transposition of the Great Arteries

et al. 2020

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A man in his 40s with a history of congenitally corrected transposition of the great arteries (CCTGA) and closure of ventricular septal defect was referred to our hospital with purpura and hematuria. Presence of purpura, renal damage, and pathological findings on skin biopsy led to the diagnosis of IgA vasculitis (IgAV). Oral prednisolone (PSL) was initiated. However, Streptococcus pseudoporcinus was isolated from blood cultures, and transthoracic echocardiogram revealed vegetation on the pulmonary valve. From these findings, the diagnosis of infective endocarditis (IE) was made. Although the patient's condition improved after PSL interruption and antibiotic administration, his purpura relapsed. PSL readministration improved symptoms, with no further relapse even after gradual PSL dose reduction. The present case raises awareness of the importance of recognizing the occurrence of IE in IgAV patients, especially in those with congenital heart disease. CCTGA should be acknowledged as a risk factor for IE in the right-sided heart.

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“…Another report documented leukocytoclastic vasculitis with perivascular IgA deposition in a 47-year-old man who presented with fever, asthenia, and weight loss, which resolved on treatment of S gallolyticus endocarditis of the aortic, mitral, and tricuspid valves. 6 Other cases of endocarditisassociated HSP also featured high fevers up to 1048F, which prompted blood cultures that helped establish the diagnosis. 7,8 Here we describe 2 initially afebrile, wellappearing patients ultimately found to have subacute endocarditis as the most likely cause for their IgA vasculitis.…”

Section: Discussionmentioning

confidence: 99%