RT Journal
A1 Anthony DD, Askari AD, Wolpaw T, McComsey G
T1 WEgener granulomatosis simulating bacterial endocarditis
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1999
FD August 9
VO 159
IS 15
SP 1807
OP 1810
DO 10.1001/archinte.159.15.1807
UL http://dx.doi.org/10.1001/archinte.159.15.1807
AB 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.