SHM Converge Scientific Abstract ePoster Gallery-B Symptoms or ... Sbe Symptoms

Pdf Summary

A 61-year-old man with COPD, coronary artery disease, and tobacco use presented with 3 months of fever, night sweats, and 30 kg weight loss. Initial imaging showed marked splenomegaly and retroperitoneal lymphadenopathy, raising concern for malignancy or another cause of “B symptoms.” On further evaluation, he was found to have Streptococcus parasanguinis infective endocarditis, including a large pulmonic valve vegetation on transthoracic echocardiogram.<br /><br />The key teaching point is that subacute bacterial endocarditis can present with nonspecific symptoms such as fever, malaise, weight loss, and night sweats, and may mimic lymphoma or other malignancy. Splenomegaly can occur in a minority of cases, and in patients with constitutional symptoms plus splenomegaly, clinicians should consider indolent infection as well as cancer in the differential diagnosis.<br /><br />The case emphasizes the importance of broad evaluation when systemic symptoms and organ enlargement are present, especially in patients with risk factors for infection or unclear initial work-up.

Asset Subtitle

Xiaoling Yu

Meta Tag

Author List Jean Miller, Xiaoling Yu

Category Clinical Vignettes

Concept Subacute Endocarditis

Concept Infective Endocarditis

Concept Splenomegaly

Concept Constitutional Symptoms

Concept Fever

Distinguished Non-Finalist

Presenter Organization Internal Medicine Residency Program, Hospital of the University of Pennsylvania

Presenting Author Xiaoling Yu

Track Adult

Keywords

subacute bacterial endocarditis

Streptococcus parasanguinis

pulmonic valve vegetation

splenomegaly

retroperitoneal lymphadenopathy

fever

night sweats

weight loss

B symptoms

infective endocarditis

Subacute Endocarditis

Infective Endocarditis

Splenomegaly

Constitutional Symptoms

Fever