title: Henoch-Schonlein purpura secondary to subacute bacterial endocarditis.
abstract: Henoch-Schönlein purpura (HSP), a systemic, small-vessel vasculitic syndrome, is characterized by a nonthrombocytopenic purpuric rash, arthralgia, abdominal pain, and nephritis. These signs and symptoms may occur in any order, and not all are necessary for the diagnosis. Although most common in 4- to 7-year-olds, HSP is well documented in adults and is often preceded by a history of mucosal-based infections, especially of the upper respiratory tract. We report a case of HSP that occurred coincident with the onset of subacute bacterial endocarditis (SBE) in an otherwise healtny 41-year-old white woman. The patient presented with a purpuric rash and arthralgia and was found to have left-sided streptococcal SBE. She subsequently developed abdominal pain and immune complex glomerulonephritis. The bacterial endocarditis was treated with antibiotics and mitral valve replacement, followed by a spontaneous resolution of the associated signs and symptoms of HSP.
authors.affiliation: Department of Dermatology, Strong Memorial Hospital, University of Rochester, New York, USA.
authors.forename: Noreen A
authors.initials: NA
authors.lastname: Galaria
authors.forename: Nick P
authors.initials: NP
authors.lastname: Lopressti
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Magro
mesh_terms: D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic; D000936:Antigen-Antibody Complex; D003937:Diagnosis, Differential; D004698:Endocarditis, Subacute Bacterial / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D011695:IgA Vasculitis / Q000209:etiology*; D013290:Streptococcal Infections / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D013298:Streptococcus sanguis / Q000302:isolation & purification*
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D000936:Antigen-Antibody Complex