Two cases of acute endocarditis misdiagnosed as COVID‐19 infection

Abstract

The COVID-19 pandemic caused by the SARS-CoV-2 virus presents new diagnostic challenges including differentiating COVID-19 infection from other diagnostic entities. Both COVID-19 infection and acute endocarditis may present with hypoxic respiratory failure, fever, and elevated inflammatory biomarkers. The task of distinguishing the two is complicated by the complexities of interpreting SARS-CoV-2 RT-PCR test results. The RT-PCR test may be negative early in the disease course 1-3 and may remain positive long after the initial infection due to viral clearance delay. 4,5 Here, we present two cases of left-sided endocarditis, which were both initially attributed to COVID-19 infection, and only correctly diagnosed after echocardiography was performed.

A clinical profile of infective endocarditis in patients with recent COVID-19: A systematic review

“…Twenty-one cases from 20 publications that satisfied inclusion criteria were identified 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ( Figure 1 ). There were 8 cases in the United States, 7 in Europe (Italy 3, Spain 2, United Kingdom 1 and Greece 1), 3 in the Middle East (Iran, Morocco, Tunisia), 2 in South America (Brazil and Ecuador), and 1 in Asia (Indonesia).…”

Bacterial endocarditis masked by COVID‑19: A case report

“…Endocarditis can be overlooked in patients with COVID-19, as SARS-CoV-2, acute respiratory distress syndrome and inflammatory syndrome can mask the symptoms. Still, the reported endocarditis cases revealed gram-negative germs, especially Klebsiella pneumoniae and Enterococcus faecium (7,8).…”

Association of recurrent fever and anemia with infective endocarditis in a 13-year-old girl with bicuspid aortic valve

“…Patients with IE and BAV were also significantly younger and had similar rates of intracardiac complications as high-risk patients [4]. As of recently, we must also consider that COVID-19 infection and acute endocarditis may present similarly, yet with very different treatments [5].…”