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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
BMJ Case Rep. 2010; 2010: bcr07.2009.2060.
Published online Mar 17, 2010. doi:  10.1136/bcr.07.2009.2060
PMCID: PMC3029115
Unusual association of diseases/symptoms
Endocarditis presenting as acute abdomen
Hassan Hatab,1 Furat Wahab,2 and Hossam El-Mahy3
1Lancashire Teaching Hospital, Preston Road, Chorley PR7 1BT, UK
2Chorley District Hospital, MAU, Preston Road, Chorley PR7 1PP, UK
3Tameside Hospital, Cardiology, Fountain Street, Lancashire, Ashton-under-Lyne OL6 9RW, UK
Correspondence to Hassan Hatab, hassan.hatab/at/
Infective endocarditis remains an interesting and challenging disease in which the presenting features have been modified by medical progress. We report a case of a 63-year-old woman who presented with pyrexia, weight loss, night sweats and fatigue over a period of 7 weeks, at the end of which she developed severe right hypochondrial pain, mimicking acute abdomen. She was provisionally diagnosed with and treated for acute cholecystitis to no avail. An abdominal computed tomography scan was performed and revealed the presence of right kidney infarction, the source of which was later proven to originate from aortic valve endocarditis. The patient made a remarkable recovery following 6 weeks of treatment with intravenous antibiotics. This case demonstrates that endocarditis can present as an acute abdomen which is caused mainly by embolism in various organs (the kidney in our patient).
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