Leukocytoclastic vasculitis associated with endocarditis in a patient with transposition of the great arteries and mechanical valve replacement.
Immunological vascular phenomena can be the initial manifestation of bacterial infection and endocarditis. Here, we report a rare case of leukocytoclastic vasculitis without immune complexes or cryoglobulinemia in a patient with infective endocarditis, congenital heart disease, and a prior mechanical valve replacement. The patient completely recovered following antibiotic therapy, and skin lesions disappeared without immune suppression, which suggested infection-mediated vasculitis. While the treatment of leukocytoclastic vasculitis typically involves immunosuppressive therapy, the treatment for infection-mediated vasculitis is eradication of the infection.
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. Electronic address: riehle.christian@mh-hannover.de.
Christian
C
Riehle
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Gesine M
GM
Scharf
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Jan-Thorben
JT
Sieweke
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Florian
F
Zauner
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Ulrike
U
Flierl
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Jens
J
Treptau
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Christos
C
Zormpas
Department of Pathology, Hannover Medical School, Hannover, Germany.
Jana
J
Senf
Department of Biochemistry, University of Iowa, Iowa City, IA, USA.
Nicholas S
NS
McCarty
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Johann
J
Bauersachs
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Daniel G
DG
Sedding
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Mechthild
M
Westhoff-Bleck
D000328:Adult; D004697:Endocarditis, Bacterial / Q000150:complications*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D011183:Postoperative Complications; D013203:Staphylococcal Infections / Q000150:complications; D014188:Transposition of Great Vessels / Q000150:complications*; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000209:etiology*
Congenital heart disease; Endocarditis of a prosthetic valve; Leukocytoclastic vasculitis; Transposition of the great arteries