Infect Chemother.  2011 Oct;43(5):416-420. 10.3947/ic.2011.43.5.416.

A Case of Libman-Sacks Endocarditis that Developed after Infective Endocarditis

• Jin SJ
• Yoon JH
• Kim HW
• Kim H
• Yoon JH
• Rim SJ
• Song YG

• KMID: 2285015
• DOI: http://doi.org/10.3947/ic.2011.43.5.416

Abstract

Libman-Sacks endocarditis (LSE) is a valvular heart disease that is associated with autoimmune diseases such as systemic lupus erythematosus and antiphospholipid syndrome (APS). Cases of LSE and APS associated with infection have been reported during the last several years. Herein, we present a patient who was suspected to have developed LSE and catastrophic APS during the treatment of her definite infective endocarditis, which was caused by Staphylococcus aureus, and the patient's condition was complicated with cerebral abscess, sensorineural hearing loss, endophthalmitis, renal infarction, splenic abscess, and septic arthritis.

Keyword

Libman-Sacks endocarditis; Infective endocarditis; Antiphospholipid syndrome; Embolism

MeSH Terms

Abscess
Antiphospholipid Syndrome
Arthritis, Infectious
Autoimmune Diseases
Brain Abscess
Embolism
Endocarditis
Endophthalmitis
Hearing Loss, Sensorineural
Heart Valve Diseases
Humans
Lupus Erythematosus, Systemic
Splenic Infarction
Staphylococcus aureus

Figure

• 

  Figure 1 Multiple small Janeway lesions (narrow arrow) and one Osler node (thick arrow) are seen on the medial side of the left leg.

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  Figure 2 The abdomen computed tomographic scan shows multiple renal infarctions (A) and splenic microabscesses with splenomegaly (about 13 cm in size) (B).

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  Figure 3 Cerebral magnetic resonance imaging reveals multifocal brain abscesses. The lesions of rim enhancement with central necrosis on the enhanced T1-weighted image are shown in the cerebellum (A) and the right hemisphere (B).

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  Figure 4 Transthoracic echocardiography shows a mobile, round, heterogeneous echogenic material with a smooth surface at the posterior mitral valve, which exhibits no independent motion (A). Transesophageal echocardiography reveals a 1.5 × 0.9 cm sized oval mass located on the atrial side of the posterior mitral leaflet (B). RV, right ventricle; LA, left atrium; PA, pulmonary artery; LV, left ventricle; RA, right atrium

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