Author: Hayes, Dena E.; Rhee, David W.; Hisamoto, Kazuhiro; Smith, Deane; Ro, Richard; Vainrib, Alan F.; Bamira, Daniel; Zhou, Fang; Saric, Muhamed
Title: Two cases of acute endocarditis misdiagnosed as COVIDâ€19 infection Cord-id: v0ea2bos Document date: 2021_3_13
ID: v0ea2bos
Snippet: The COVIDâ€19 pandemic has presented countless new challenges for healthcare providers including the challenge of differentiating COVIDâ€19 infection from other diseases. COVIDâ€19 infection and acute endocarditis may present similarly, both with shortness of breath and vital sign abnormalities, yet they require very different treatments. Here, we present two cases in which lifeâ€threatening acute endocarditis was initially misdiagnosed as COVIDâ€19 infection during the height of the pandem
Document: The COVIDâ€19 pandemic has presented countless new challenges for healthcare providers including the challenge of differentiating COVIDâ€19 infection from other diseases. COVIDâ€19 infection and acute endocarditis may present similarly, both with shortness of breath and vital sign abnormalities, yet they require very different treatments. Here, we present two cases in which lifeâ€threatening acute endocarditis was initially misdiagnosed as COVIDâ€19 infection during the height of the pandemic in New York City. The first was a case of Klebsiella pneumoniae mitral valve endocarditis leading to papillary muscle rupture and severe mitral regurgitation, and the second a case of Streptococcus mitis aortic valve endocarditis with heart failure due to severe aortic regurgitation. These cases highlight the importance of careful clinical reasoning and demonstrate how cognitive errors may impact clinical reasoning. They also underscore the limitations of realâ€time reverse transcriptionâ€polymerase chain reaction (RTâ€PCR) for SARSâ€CoVâ€2 testing and illustrate the ways in which difficulty interpreting results may also influence clinical reasoning. Accurate diagnosis of acute endocarditis is critical given that surgical intervention can be lifesaving in unstable patients.
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