Livedo reticularis revealing a latent infective endocarditis due to Coxiella burnetti

Granel, B.; Genty, I.; Serratrice, Jacques; Rey, Jérôme; Disdier, P.; Raoult, Didier; Weiller, Pierre‐Jean

doi:10.1016/s0190-9622(99)70340-3

Cited by 15 publications

(4 citation statements)

References 6 publications

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“…80 Coxiella burnetii may cause LR associated with both acute and chronic Q fever. 81,82 The proposed origin varies with the type of Q fever. Direct microorganism damage of the endothelium is believed responsible for the LR in the acute form, whereas deposition of immune complexes in the endothelium is causative in the chronic form.…”

Section: Infectious Diseasementioning

confidence: 99%

Livedo reticularis: An update

Gibbs

English

Zirwas

2005

Journal of the American Academy of Dermatology

120

121

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Section: Infectious Diseasementioning

confidence: 99%

Livedo reticularis: An update

Gibbs

English

Zirwas

2005

Journal of the American Academy of Dermatology

120

121

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“…Interestingly, our patient presented with asymmetrical livedo reticularis across the anterior aspect of both knees (figure 1). This cutaneous manifestation may represent peripheral emboli from the vegetation, an association that has previously been reported in the literature 6 7. Although, in rare cases, atrial myxoma is also thought to be associated with livedo reticularis 8.…”

Section: Discussionmentioning

confidence: 75%

Unusual cause of infective endocarditis in an elderly patient with a rare condition

et al. 2015

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A 77-year-old woman presented to the emergency department with a 1-week history of anorexia, fatigue, general malaise and a 3-day history of fever. Clinical examination revealed livedo reticularis across the anterior aspect of her knees and a pansystolic murmur. Laboratory evaluation found neutrophil leucocytosis; elevated C reactive protein and blood cultures grew Streptococcus acidominimus. Transthoracic echocardiography displayed vegetation on the mitral valve and a left atrial myxoma. She was treated with intravenous benzylpenicillin and erythromycin for the infective endocarditis (IE) and remains well 3 months post-treatment. S. acidominimus is considered a common veterinary pathogen rarely found in humans. To the best of our knowledge, only two prior reports of IE due to this organism exist in the literature. This case highlights how rare pathogens can cause unusual presentation and the importance of IE as a differential even in the absence of classical signs, if fever and new murmur are present.

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“…This happens because many of the characteristics are shared by the two diseases (fever, rash, glomerulonephritis/evidence of renal disease, low C4 complement component, presence of mixed type II cryoglobulin, constitutional symptoms such as fatigue, arthralgia). As transesophageal echocardiograms are usually normal and blood cultures are usually negative in Q fever endocarditis, many of these clinical manifestations can be attributed to Mixed cryoglobulinemia type II per se [[ 7 - 11 ]]. Thus problems of differential diagnosis arise.…”

Section: Discussionmentioning

confidence: 99%

Q fever endocarditis masquerading as Mixed cryoglobulinemia type II. A case report and review of the literature

2006

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BackgroundThe clinical manifestations of Q fever endocarditis are protean in nature. Mixed cryoglobulinemia type II is rarely a facet of the presenting clinical manifestations of Q fever endocarditis.Case presentationWe report a case of a 65-year-old pensioner with such an association and review the literature. As transesophageal echocardiograms are usually normal and blood cultures are usually negative in Q fever endocarditis, many of the manifestations (fever, rash, glomerulonephritis/evidence of renal disease, low serum C4 complement component, presence of mixed type II cryoglobulin, constitutional symptoms as arthralgias and fatigue) can be attributed to Mixed cryoglobulinemia type II per se. The use of Classic Duke Endocarditis Service criteria does not always suffice for the diagnosis of Q fever.ConclusionThe application of the modified criteria proposed by Fournier et al for the improvement of the diagnosis of Q fever endocarditis will help to reach the diagnosis earlier and thus reduce the high mortality of the disease. We would like to stress the importance of ruling out the diagnosis of Q fever endocarditis in cases of mixed type II cryoglobulinemia.

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Livedo reticularis revealing a latent infective endocarditis due to Coxiella burnetti

Cited by 15 publications

References 6 publications

Livedo reticularis: An update

Livedo reticularis: An update

Unusual cause of infective endocarditis in an elderly patient with a rare condition

Q fever endocarditis masquerading as Mixed cryoglobulinemia type II. A case report and review of the literature

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