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, Mitral Valve Stenosis, Multimorbidity, Rheumatic Diseases, Risk Assessment, Streptococcal Infections, Streptococcus mutans, Stroke

Add Comment 0 Comments

In Press

Case report  USA

A Rare Complication of Cannabinoid Hyperemesis Syndrome

Am J Case Rep In Press; DOI: 10.12659/AJCR.945106  

0:00

Case report  Japan

Dynamic Ultrasound Assessment of Celiac Artery Flow Velocity in Median Arcuate Ligament Syndrome Diagnosis

Am J Case Rep In Press; DOI: 10.12659/AJCR.945253  

Case report  China

Recurrent Heterotopic Pregnancy Following Frozen-Thawed Embryo Transfer: A Case Study and Comprehensive Lit...

Am J Case Rep In Press; DOI: 10.12659/AJCR.945053  

Case report  Lebanon

Iron-Related Pseudomelanosis Duodeni in a Patient with Gastrointestinal Bleeding: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.945238  

Most Viewed Current Articles

21 Jun 2024 : Case report  China (mainland) 57,486

Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...

DOI :10.12659/AJCR.944371

Am J Case Rep 2024; 25:e944371

0:00

07 Mar 2024 : Case report  USA 42,466

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

10 Jan 2022 : Case report  Germany 32,431

A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...

DOI :10.12659/AJCR.935263

Am J Case Rep 2022; 23:e935263

23 Feb 2022 : Case report  USA 19,902

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