Establishing the Diagnosis of Libman–Sacks Endocarditis in Systemic Lupus Erythematosus
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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.
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.
This case highlights the challenges of making the correct diagnosis when 2 disease processes present with similar findings.