Kingella endocarditis and meningitis in a patient with SLE and associated antiphospholipid syndrome

Abstract

We describe a patient with SLE and antiphospholipid syndrome who presented with severe headache and fever. Lumbar puncture analyses indicated meningitis. Kingella kingae was isolated from her blood cultures. A large mobile vegetation was seen on her mitral valve. The association between SLE, Libman – Sacks endocarditis and bacterial endocarditis is discussed.

Keywords

Kingella SLE endocarditis antiphospholipid antibodies meningitis

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References

Watanabe-Duffy KN , Duffy CM , Gladman DD . Infection and disease activity in SLE: a review of hospitalized patients . J Rheumatol 1991; 18: 1180–1184 .

Abu-Shakra M , Urowitz MB , Gladman DD , Gough J . Mortality studies in SLE. Results from a single center. I. Causes of death . J Rheumatol 1995; 22: 1259–1264 .

Lehman TJA , Palmeri ST , Hastings C et al. Bacterial endocarditis complicating SLE . J Rheumatol 1983; 10: 655–658 .

Roldan CA , Shively BK , Crawford MH . An echocardiographic study of valvular heart disease associated with SLE . N Eng J Med 1996; 335: 1424–1430 .

Libman E , Sacks B . A hitherto undescribed form of valvular and mural endocarditis . Arch Intern Med 1924; 33: 701-701 .

Doherty NE , Siegel RJ . Cardiovascular manifestations of SLE . Am Heart J 1985; 110: 1257–1263 .

Tornos MP , Galve E , Pahissa A . Clinical considerations regarding infective Libman-Sacks endocarditis . Int J Cardiol 1985; 7: 409–412 .

Khamashta M , Cervera R , Asherson RA et al. Association of antibodies against phospholipids with heart valve disease in systemic lupus erythematosus . Lancet 1990; 335: 1541–1544 .

Amital H , Langevitz P , Levy Y et al. Valvular deposition of anti-phospholipid antibodies in the antiphospholipid syndrome: a clue to the origin of the disease . Clin Exp Rheumatol 1999; 17: 99–102 .

10.

Afek A , Shoenfeld Y , Manor R et al. Increased endothelial cell expression of a-3-b-1 integrin in cardiac valvulopathy in the primary (Hughes) and secondary antiphospholipid syndrome . Lupus 1999; 8: 502–507 .

11.

Morrison VA , Wagner KF . Manifestations of Kingella kingae infections: Case report and review . Rev Inf Dis 1989; 11: 776–782 .

12.

Wolff AH , Ullman RF , Strampfer MJ , Cunha BA . Kingella kingae endocarditis: report of a case and review of the literature . Heart Lung 1987; 16: 579–583 .

13.

Yagupsky P , Dagan R . Kingella kingae: an emerging cause of invasive infections in young children . Clin Infect Dis 1997; 24: 860–866 .