Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 1-2, Pages: 85-88
https://doi.org/10.2298/SARH1302085I
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Infective endocarditis - maybe yes, maybe no: Case report
Ivanović Branislava (Klinički centar Srbije, Klinika za kardiologiju, Beograd + Medicinski fakultet, Beograd)
Tadić Marijana (Klinički centar Srbije, Klinika za kardiologiju, Beograd)
Orbović Bojana (Klinički centar Srbije, Klinika za kardiologiju, Beograd)
Petrović Milan (Klinički centar Srbije, Klinika za kardiologiju, Beograd + Medicinski fakultet, Beograd)
Introduction. Infective endocarditis (IE) is a rare disease which manifests
in different ways. Case Outline. We are presenting a female patient who was
suspected of IE based on the presence of fever, accelerated erythrocyte
sedimentation rate, increased levels of C-reactive protein and
echocardiographic findings of filamentous structures on the aortic valve
which were assumed to be vegetation. Because of the well-known fact that in
the pre-antibiotic era IE was almost always a fatal disease, empirical
antibiotic therapy was conducted despite the absence of clear criteria for IE
and it resulted in a satisfactory outcome. The course of the disease and the
persistence of echocardiographic findings with a completely competent aortic
valve, suggested us to consider the diagnosis of Lambl’s excrescences. There
was no indication for surgical treatment in our patient; so that in the
absence of pathological confirmation our diagnostic dilemma was left
unresolved. Conclusion. In patients with typical clinical features of IE and
filamentous structures on the cardiac valves that are completely competent,
Lambl’s excrescences should be kept in mind as a possible differential
diagnosis.
Keywords: infective endocarditis, Lambl’s excrescences, treatment