Case Report of Infectious endocarditis complicated by lumbar purulent spondylitis diagnosed by acute radial artery occlusion

Abstract Introduction; Infective endocarditis (IE) is a rare but serious disease with a wide range of phenotypes and clinical courses. The diagnosis of IE is often difficult and must be comprehensively judged. Case Presentation; We report the case of a 78-year-old woman with back pain and fever of unknown origin, who was transferred to our hospital due to acute radial artery occlusion. We diagnosed purulent spondylitis and IE. The mobile vegetation remained in the anterior mitral valve leaflet after embolism, and the embolism to the central nervous system was relatively mild, so we decided to perform early surgery. Mitral valve replacement was performed because of embolic symptoms without further complications. Conclusions; Early evaluation by echocardiography is required for the prompt diagnosis of IE and its associated high-risk features may benefit from surgical intervention. Early diagnosis of infective endocarditis and surgical intervention are associated with better outcome in patients with large vegetations, recurrent embolisms, and heart failure. While purulent spondylitis is not commonly associated with infective endocarditis, it is important to actively suspect the existence of IE in patients who complain of back pain along with fever. Both physicians and orthopedic surgeons need to recognize IE as a common disease, especially in the elderly society.