A CASE OF INFECTIVE ENDOCARDITIS WITH HENOCH-SCHONLEIN PURPURA AS THE PRESENTING MANIFESTATION
Rashna Dass*, Neil Bardolai**, Vandana Raphael***
From the Department of Pediatrics, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong. *, Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong. **, Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong. ***
Abstract
Cutaneous vasculitis such as Henoch-Schonlein purpura (HSP), a systemic small vessel vasculitic syndrome presents a diagnostic and therapeutic challenge because it may be a primary disorder or it may be a cutaneous manifestation of a more ominous disease such as systemic necrotizing vasculitis, connective tissue disease, systemic bacterial infection, or malignancy. HSP is commonly seen in young children and most often follows a mucosal based infection such as an upper respiratory tract infection. We discuss a young boy of established rheumatic heart disease who manifested as HSP about 15 days prior to the clinical manifestations of a left sided infective endocarditis. The rash of HSP showed a spontaneous resolution with the treatment of bacterial endocarditis with antibiotics. Subsequently the child is on penicillin prophylaxis for rheumatic heart disease and asymptomatic for the last 6 months.

Keywords: Henoch-Schonlein purpura, infective endocarditis, rheumatic heart disease
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