Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

18 April 2019 : Case report  USA

Cardiac Point-of-Care Ultrasound for the Diagnosis of Infective Endocarditis in a Patient with Non-Specific Rheumatologic Symptoms and Glomerulonephritis

Mistake in diagnosis

Brett G. Fischer1BEF*, Amiran Baduashvili1BEF

DOI: 10.12659/AJCR.914708

Am J Case Rep 2019; 20:542-547

Abstract

BACKGROUND: Point-of-care ultrasound (POCUS) is performed at the bedside by a healthcare professional who is directly caring for the patient. Subacute infective endocarditis can be challenging to diagnose, as patients often present with non-specific symptoms. The modified Duke criteria include echocardiographic findings as a major criterion, but the role of POCUS has not been established. This report is of a case of infective endocarditis diagnosed using POCUS.

CASE REPORT: A 57-year-old man was admitted to hospital with a presumptive diagnosis of rapidly progressive glomerulonephritis secondary to vasculitis associated with a non-specific rheumatologic condition that had developed during the previous three months. Several specialist physicians had previously examined him. On hospital admission, POCUS was performed by the internal medicine physician, which showed mitral valve endocarditis resulting in a change in clinical management from steroid therapy to antibiotic therapy. Blood cultures were performed, which grew Streptococcus mutans.

CONCLUSIONS: To our knowledge, this is the first reported case of infective endocarditis diagnosed by an internist using POCUS in a patient admitted to hospital with an alternative diagnosis and management plan in place. This case highlights the potential role of POCUS in the acute hospital setting and supports the need for studies to compare the diagnostic performance of POCUS with transthoracic echocardiography for the detection of valvular vegetations. POCUS may be considered for patients with a possible diagnosis of infective endocarditis that cannot be excluded using the modified Duke criteria, potentially resulting in earlier diagnosis and management, with an improved clinical outcome.

Keywords: Early Diagnosis, Echocardiography, Endocarditis, Internal Medicine, Point-of-Care Systems, Ultrasonography, Anti-Bacterial Agents, conservative treatment, Echocardiography, Doppler, Emergency Service, Hospital, Endocarditis, Bacterial, Follow-Up Studies, Glomerulonephritis, Middle Aged, Mitral Valve Stenosis, Multimorbidity, Rheumatic Diseases, Risk Assessment, Streptococcal Infections, Streptococcus mutans, Stroke, Treatment Outcome

Add Comment 0 Comments

1115 8

In Press

31 May 2023 : Case report  Saudi Arabia

Preoperative Clinical Prediction of Parathyroid Carcinoma: Two Rare Case Presentations and a Review of Lite...

Am J Case Rep In Press; DOI: 10.12659/AJCR.940611  

31 May 2023 : Case report  USA

Inflammatory Arthritis After COVID-19: A Case Series

Am J Case Rep In Press; DOI: 10.12659/AJCR.939870  

31 May 2023 : Case report  Japan

Condyle Fracture Fixed with Custom-Made Titanium Mesh and a Miniplate: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.940681  

31 May 2023 : Case report  USA

The Reemerging Condition of Vaccinia: A Case Report and Brief Review of Monkeypox and Vaccinia Vaccines

Am J Case Rep In Press; DOI: 10.12659/AJCR.941006  

Most Viewed Current Articles

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

07 Dec 2021 : Case report  USA

Edwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...

DOI :10.12659/AJCR.934347

Am J Case Rep 2021; 22:e934347

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923