Infective Endocarditis Mimicking Reactive Arthritis: A Diagnostic Detour.

Hudson Lin, Claudia See, Neal Shah, Soonmee Cha, Kirk Jones, Kreshnik Zejnullahu

Abstract readCase Reports

In one paragraph

Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Hudson LinDepartment of Medicine, University of California-San Francisco, San Francisco, California, USA; School of Medicine, University of California-San Francisco, San Francisco, California, USA.

Claudia SeeDepartment of Medicine, University of California-San Francisco, San Francisco, California, USA.

Neal ShahDivision of Cardiology, Department of Medicine, University of California-San Francisco, San Francisco, California, USA.

Soonmee ChaDepartment of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California, USA.

Kirk JonesDepartment of Pathology, University of California-San Francisco, San Francisco, California, USA.

Kreshnik ZejnullahuDepartment of Medicine, University of California-San Francisco, San Francisco, California, USA. Electronic address: kreshnik.zejnullahu@ucsf.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInfective endocarditis (IE) in young adults can present with nonspecific symptoms mimicking alternative diagnoses. CASE SUMMARY: A 29-year-old man presented to the emergency department with erythematous, pruritic papules on his shins and ankles with bilateral knee pain and swelling. After the initial work-up for septic or inflammatory arthritis, he was empirically treated for reactive arthritis with systemic steroids. A month later, he re-presented with headache, dark urine, and unintentional 40-lb weight loss. Imaging revealed multiple ischemic strokes in the bilateral cerebelli and right thalamus. He received a diagnosis of Streptococcus mitis endocarditis with severe aortic regurgitation and septic brain emboli, underwent mechanical aortic valve replacement, and was treated for 4 weeks with antibiotics. DISCUSSION: Nonspecific symptoms of IE can delay diagnosis and risk complications, including stroke and valvular destruction. Reactive arthritis should remain a diagnosis of exclusion. TAKE-HOME MESSAGE: Maintain suspicion for IE in patients with unexplained systemic inflammation and arthralgias.

Indexed as

aortic regurgitationdiagnostic delayseptic emboliStreptococcus mitisyoung adult

Identifiers

PMID42171576

DOI10.1016/j.jaccas.2026.108473

PMCPMC13332626

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