A Case of Acute Infective Endocarditis Initially Presenting as Acute Pyelonephritis.
- Author:
Youn Hee LEE
1
;
Jin Hee LEE
;
Bo Mi CHOI
;
Young Jae KO
;
Soo Kyoung CHOI
;
Yeong Bok LEE
;
Young Min KIM
;
Young Ok KIM
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. cmckyo@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
Bacterial endocarditis;
Pyelonephritis;
Staphylococcus aureus
- MeSH:
Adult;
Anti-Bacterial Agents;
Aortic Valve;
Aortic Valve Insufficiency;
Diagnosis;
Early Diagnosis;
Echocardiography;
Endocarditis*;
Endocarditis, Bacterial;
Female;
Fever;
Flank Pain;
Humans;
Mortality;
Physical Examination;
Pyelonephritis*;
Pyuria;
Staphylococcus aureus;
Thoracic Surgery
- From:Journal of the Korean Society of Emergency Medicine
2015;26(6):605-608
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Infective endocarditis carries high risk of morbidity and mortality. Rapid diagnosis and effective treatment are essential to good patient outcome. However, nonspecific symptoms and various clinical manifestations make early diagnosis difficult. Here we report on an unusual case of infective endocarditis initially presenting as acute pyelonephritis (APN). A 44-year-old female with a history of heart surgery was admitted for fever and both flank pain. The patient had undergone dental extraction 3 weeks prior to admission. Her lab work and physical examination revealed pyuria, positive bacterial culture of both blood and urine, costovertebral knocking tenderness, and CT findings consistent with APN, leading to her initial diagnosis as APN. Despite treatment with antibiotics, her symptoms did not improve while further physical examination revealed newly developed Osler's nodes and Janeway lesions. Echocardiography showed vegetation of the aortic valve with severe aortic regurgitation. She was diagnosed as a case of infective endocarditis and was treated successfully.
