0
Clinical Observation |

Wegener Granulomatosis Simulating Bacterial Endocarditis

Donald D. Anthony, MD, PhD; Ali D. Askari, MD; Terry Wolpaw, MD; Grace McComsey, MD
Arch Intern Med. 1999;159(15):1807-1810. doi:10.1001/archinte.159.15.1807.
Text Size: A A A
Published online

Cardiac involvement in Wegener granulomatosis is uncommon. We report a case of Wegener granulomatosis that presented as culture-negative endocarditis with aortic valvular vegetation. The clinical manifestations included gingival hyperplasia, gangrenous digital infarcts, mononeuritis multiplex, high fever, inflammatory arthritis, pansinusitis, splenic infarct, and aortic valvular vegetation, which underscore the difficulty of distinguishing systemic vasculitis from bacterial endocarditis. Contrary to the common notion that valvular vegetation is invariably associated with bacterial endocarditis, this case proves that such findings can occur in Wegener granulomatosis as well. Clinicians are guided toward early treatment with corticosteroids and cyclophosphamide to prevent fatal complications.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Place holder to copy figure label and caption
Figure 1.

A, Infarct on tip of right index finger and cutaneous lesions on right palm. Biopsy sutures are present. B, Punctate nonraised ecchymotic lesions on dorsum of left foot.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Histologic findings in a hematoxylin-eosin–stained skin biopsy specimen obtained from a lesion overlying the left lateral hip area. A, A ×4 magnification reveals the deep dermal location of the well-demarcated inflammatory focus. B, A ×10 magnification of the same section reveals central eosinophilic amorphous deposit infiltrated by neutrophils and surrounded by epithelioid histiocytes (arrow). C, A ×40 magnification of the area indicated by the arrow in B. The arrow in this section highlights a smooth muscle remnant, indicating that this thrombotic neutrophilic and granulomatous process involves a medium-sized muscular artery.

Graphic Jump Location

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 14

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();