A Misdiagnosed Case of Subacute Infective Endocarditis Presented with Only Fever and the Literature Review
LI Ping-zhu
WANG Yue-yue
BAN Yu
MENG Qing-yi
Abstract：Objective To explore the clinical characteristics, diagnosis and treatment of infectious endocarditis, and to reduce the misdiagnosis rate. Methods Clinical data of a patient with subacute infectious endocarditis in our hospital were retrospectively analyzed and related literatures were also reviewed. Results The 28-year-old female patient was admitted to hospital for prolonged low-grade fever for more than two months and with the past history of artificial abortion about one week before the onset. The patient had been diagnosed and received treatment in different local hospitals. She was examined with la-boratory and imaging testing in a local institution, but could not be definitively diagnosed. The patient received treatment of antibiotics and abatement of fever, but her symptoms had no mitigation. Upon admission to our hospital, the patient improved in all the relevant tests, and results appeared normal. Broad-spectrum antibiotics were administered for 3 day. The patient still had a fever. Clinicians suspended antibiotic therapy for 2 days for fear of suspected drug fever, but the patient's symptoms had no remission. Echocardiography was measured again and showed valve excrescence, valvular regurgitation. The repeated blood culture was streptococcus. So definite diagnosis of subacute infective endocarditis was made. After treatment of teicoplanin for 3 days, and the patient's temperature returned to normal. The patient was discharged 13 days after treatment. Conclusion The clinical manifestations of infectious endocarditis are diversified, and apt to be misdiagnosed. Clinicians should consider the disease when patients suffer from long-term low-grade fever but laboratory and imaging testing results are normal. In order to make accurate diagnosis of the disease, clinicians should focus on the heart valves when making echocardiography.
Keywords：Fever of unknown originEndocarditisbacterialEchocardiographyBlood cultureMisdiagnosisRe-spiratory tract infection
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 42-45 )