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Subacute Bacterial Endocarditis Presenting as Purpura

Subacute Bacterial Endocarditis Presenting as Purpura Abstract PURPURA is a rare occurrence in the course of subacute bacterial endocarditis (SBE) but may be a prominent sign of this disease. This report concerns two patients with streptococcal viridans-type infections of the aortic valve, who presented with such striking purpura that the possibility of a primary coagulation disorder was seriously considered before the diagnosis of SBE was established. Report of Cases Case 1.—The patient, a 57-year-old congenitally deaf white woman, was well until January 1964. Shortly following multiple tooth extractions she experienced weakness and malaise. She was found by a physician to be in mild congestive heart failure. In early February 1964, another physician found no evidence of heart failure but treated her with sulfisoxazole for hematuria. On March 3, 1964, she was admitted to Bellevue Hospital because of weakness and confusion.Physical examination revealed an emaciated woman with numerous purpuric spots on both legs and the anterior portion References 1. Jones, H.W., and Tocantins, L.M.: The History of Purpura Hemorrhagica , Ann Med Hist 5:349, 1910. 2. Weber, F.P.: Chronic Purpura of Two Years Duration Connected With Malignant Endocarditis, Wrongly Supposed to Be Connected With Splenic Anemia , Brit J Dermat 22:37, 1910. 3. Osler, W.: Chronic Infectious Endocarditis With an Early History Like Splenic Anemia , Inter-State Med J 19:103, 1912. 4. Libman, E., and Friedberg, C.K.: Subacute Bacterial Endocarditis , New York: Oxford University Press, 1941. 5. Pankey, G. A.: Subacute Bacterial Endocarditis at the University of Minnesota Hospital, 1939 Through 1959 , Ann Intern Med 55:550, 1961.Crossref 6. Stefanini, M., and Dameshek, W.: The Hemorrhagic Disorders New York: Grune and Stratton, Inc, 1955. 7. Wintrobe, M.M.: Clinical Hematology , ed 5, Philadelphia: Lea & Febiger, 1961. 8. Bauch, S.: Three Cases of Purpura Hemorrhagica in Chronic Tuberculosis , Arch Intern Med 17:44, 1916. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Subacute Bacterial Endocarditis Presenting as Purpura

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Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1967.04410010097014
Publisher site
See Article on Publisher Site

Abstract

Abstract PURPURA is a rare occurrence in the course of subacute bacterial endocarditis (SBE) but may be a prominent sign of this disease. This report concerns two patients with streptococcal viridans-type infections of the aortic valve, who presented with such striking purpura that the possibility of a primary coagulation disorder was seriously considered before the diagnosis of SBE was established. Report of Cases Case 1.—The patient, a 57-year-old congenitally deaf white woman, was well until January 1964. Shortly following multiple tooth extractions she experienced weakness and malaise. She was found by a physician to be in mild congestive heart failure. In early February 1964, another physician found no evidence of heart failure but treated her with sulfisoxazole for hematuria. On March 3, 1964, she was admitted to Bellevue Hospital because of weakness and confusion.Physical examination revealed an emaciated woman with numerous purpuric spots on both legs and the anterior portion References 1. Jones, H.W., and Tocantins, L.M.: The History of Purpura Hemorrhagica , Ann Med Hist 5:349, 1910. 2. Weber, F.P.: Chronic Purpura of Two Years Duration Connected With Malignant Endocarditis, Wrongly Supposed to Be Connected With Splenic Anemia , Brit J Dermat 22:37, 1910. 3. Osler, W.: Chronic Infectious Endocarditis With an Early History Like Splenic Anemia , Inter-State Med J 19:103, 1912. 4. Libman, E., and Friedberg, C.K.: Subacute Bacterial Endocarditis , New York: Oxford University Press, 1941. 5. Pankey, G. A.: Subacute Bacterial Endocarditis at the University of Minnesota Hospital, 1939 Through 1959 , Ann Intern Med 55:550, 1961.Crossref 6. Stefanini, M., and Dameshek, W.: The Hemorrhagic Disorders New York: Grune and Stratton, Inc, 1955. 7. Wintrobe, M.M.: Clinical Hematology , ed 5, Philadelphia: Lea & Febiger, 1961. 8. Bauch, S.: Three Cases of Purpura Hemorrhagica in Chronic Tuberculosis , Arch Intern Med 17:44, 1916.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1967

References