Establishing the diagnosis of Libman-Sacks endocarditis in systemic lupus erythematosus.
METHODS
A 43-year-old female with systemic lupus erythematosus (SLE) was admitted with fever and shortness of breath 1 month after aortic valve replacement. A diagnostic workup including chemistries, complete blood count, blood cultures, chest x-ray, and 2-D echocardiogram was performed to determine the etiology of her symptoms and differentiate between acute bacterial endocarditis and Libman-Sacks endocarditis.


CONCLUSIONS
By utilizing Duke's criteria, antiphospholipid antibodies, and serial echocardiography, we were able to make a diagnosis of Libman-Sacks endocarditis. The patient was successfully treated for Libman-Sacks endocarditis and recovered uneventfully.


CONCLUSIONS
This case highlights the challenges of making the correct diagnosis when 2 disease processes present with similar findings.
Ménard
Geraldine E
GE
Section of General Internal Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA. gmenard@tulane.edu
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008943:Mitral Valve; D011241:Prednisone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D000925:Anticoagulants; D011241:Prednisone