UTI Turns Out to Be Infective Endocarditis: An Unusual Presentation – A Case Report

This case highlights an unusual presentation for infective endocarditis (IE). The patient was initially admitted with symptoms indicative of a urinary tract infection, with a concerning and unexplained symptom of significant weight loss. As per local hospital protocol, intravenous antibiotics were initiated to treat the urinary tract infection. However, due to the patient’s persistent and unexplained weight loss, further investigations were recommended, including a CT scan of the thorax, abdomen, and pelvis to rule out malignancy or deep-seated infections. The CT scan revealed splenic infarction, prompting an echocardiogram, which subsequently showed vegetation on the aortic and mitral valves, confirming IE. Treatment for IE was promptly initiated, and a transoesophageal echocardiogram was performed. The patient underwent open-heart surgery to replace the aortic valve and repair the mitral valve. Post-surgery, the patient made an excellent recovery. Key takeaway: this case underscores the importance of maintaining a high index of suspicion, as the symptoms of IE are often nonspecific, vary widely, and can develop insidiously. Endocarditis should be considered as a differential diagnosis, particularly in patients with fever and no obvious source of infection. This case illustrates how a rare and unusual presentation of IE can be diagnosed with timely intervention, leading to a favourable outcome. Key Points 1. The clinical manifestations of infective endocarditis can vary widely, and often present with subtle or nonspecific symptoms. 2. A high index of suspicion is essential for the accurate diagnosis of infective endocarditis. 3. Early diagnosis and prompt management are crucial, as they significantly improve prognosis and patient outcomes.