Navigating Complex Diagnostics During COVID-19: Repeated Testing Unveils Infective Endocarditis in a 61-Year-Old Woman.

Publication date: Jul 13, 2023

BACKGROUND Infective endocarditis (IE), a systemic infection characterized by bacterial vegetative growths on heart valves and endothelium, often manifests variably and leads to severe complications, sometimes even death. Accurate and timely diagnosis is paramount, yet the variety of symptoms can lead to delays, especially amidst the complexities of the ongoing COVID-19 pandemic. CASE REPORT A 61-year-old woman with a history of mitral valve regurgitation was admitted after a month of low-grade fever, night sweats, and polyarthritis. Initial blood cultures and CT scans were inconclusive. Upon admission, clinical examination uncovered a heart murmur, leukocytosis, and elevated C-reactive protein levels. Further examination by another physician revealed conjunctival hemorrhage and Janeway lesions. Subsequent blood cultures tested positive for Streptococcus oralis, and transesophageal echocardiography revealed mitral valve prolapse with vegetation, leading to a diagnosis of IE. Following a 6-week course of ampicillin, the patient recovered successfully. CONCLUSIONS This case underlines the necessity of maintaining a high index of suspicion and flexible diagnostic approach, particularly in high-risk patients and complex care environments like the COVID-19 pandemic. A single inconclusive test should not preclude a diagnosis, underscoring the importance of repeated testing and comprehensive assessments in timely disease identification.

Concepts Keywords
Covid Complex
Echocardiography Covid
Leukocytosis Diagnosis
Month Endocarditis
Timely Heart


Type Source Name
disease MESH COVID-19
disease MESH Infective Endocarditis
disease MESH infection
disease MESH complications
disease MESH death
disease VO report
disease IDO history
disease MESH mitral valve regurgitation
disease MESH polyarthritis
disease IDO blood
disease MESH heart murmur
disease MESH leukocytosis
disease MESH hemorrhage
disease MESH mitral valve prolapse
drug DRUGBANK Ampicillin

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