J Korean Soc Spine Surg.  2016 Sep;23(3):166-170. 10.4184/jkss.2016.23.3.166.

Mononeuritis Multiplex as the Initial Manifestation of Candida Infective Endocarditis

• Eom KS

• KMID: 2353907
• DOI: http://doi.org/10.4184/jkss.2016.23.3.166

Abstract

STUDY DESIGN: Case report.
OBJECTIVES
To report a case of mononeuritis multiplex as the initial manifestation of Candida infective endocarditis (IE). SUMMARY OF LITERATURE REVIEW: Mononeuritis multiplex is actually a group of diseases, not a distinct disease entity. It often results from blood vessel diseases, diabetes, or inflammation due to autoimmune connective tissue disorders, although many cases are idiopathic. IE is an infection of the endocardial surface of the heart. Multiple nerves were affected simultaneously in several cases of IE, making consideration of IE important in the differential diagnosis of mononeuritis multiplex.
MATERIALS AND METHODS
We present a rare case of a 71-year-old man with IE in whom mononeuritis multiplex was revealed on electromyography; further, he presented with lower back pain and sciatica.
RESULTS
The presence of the characteristic symptoms of lumbar radiculopathy in this case delayed the diagnosis and proper treatment of the patient.
CONCLUSIONS
Physicians should carefully consider all patient-related data, and also provide accurate information to consultants when they refer patients. This can help to prevent serious complications.

Keyword

Mononeuritis multiplex; Infective endocarditis; Lumbar radiculopathy

MeSH Terms

Aged
Blood Vessels
Candida*
Connective Tissue
Consultants
Diagnosis
Diagnosis, Differential
Electromyography
Endocarditis*
Heart
Humans
Inflammation
Low Back Pain
Mononeuropathies*
Radiculopathy
Sciatica

Figure

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  Fig. 1. Gadolinium-enhanced sagittal magnetic resonance imaging (A, B) showing no significant abnormality to explain the pyogenic spondylitis.

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  Fig. 2. Transthoracic echocardiogram showing vegetation on the aortic valve (24 � 18 mm) and moderate aortic stenosis with mild aortic regurgi-tation due to vegetation: highly suggestive of infectious endocarditis. AV = aortic valve; LA = left atrium; LV = left ventricle, MV = mitral valve; RA = right ventricle.

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