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Case Reports
. 2021 Jul 1;385(1):66-72.
doi: 10.1056/NEJMcps2034802.

A Brewing Back Pain

Lauren Pischel  1 , Arnar Geirsson  1 , John Magaldi  1 , Richard A Martinello  1 , Alfred I Lee  1
Affiliations
Case Reports

A Brewing Back Pain

Lauren Pischel et al. N Engl J Med. .
No abstract available

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.. Rash on the Leg.
Hundreds of palpable, round, purpuric lesions 3 to 6 mm in diameter were noted primarily on the anterior distal lower legs.
Figure 2.
Figure 2.. Skin Biopsy.
Hematoxylin and eosin staining of a skin-biopsy specimen shows a microvascular process with erythrocyte extravasation, a suggestion of early fibrinoid necrosis of vessel walls, and possible intraluminal microthrombi (arrow).
Figure 3.
Figure 3.. Transesophageal Echocardiogram of the Mitral Valve.
Mobile echodensities measuring 0.79 cm by 0.47 cm (arrow) can be seen on the P3 leaflet.
Figure 4.
Figure 4.. Vegetation on the Posterior Leaflet of the Mitral Valve.
Panel A shows myxoid changes (arrow) of the mitral valve (hematoxylin and eosin staining). Panel B shows a mural thrombus (arrow) attached to valve leaflets (hematoxylin and eosin staining). Panel C shows gram-positive bacilli (arrow) in the mural thrombus (Brown–Hopps Gram’s staining).
See this image and copyright information in PMC

References

    1. Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation 2015; 132: 1435–86. - PubMed
    1. Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 2000; 30: 633–8. - PubMed
    1. Habib G, Derumeaux G, Avierinos JF, et al. Value and limitations of the Duke criteria for the diagnosis of infective endocarditis. J Am Coll Cardiol 1999; 33: 2023–9. - PubMed
    1. Chambers HF, Bayer AS. Native-valve infective endocarditis. N Engl J Med 2020; 383: 567–76. - PubMed
    1. DeSimone DC, Baddour LM, Lahr BD, Chung HH, Wilson WR, Steckelberg JM. Euthermic endocarditis. PLoS One 2013; 8(11): e80144. - PMC - PubMed

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