Abiotrophia endocarditis: The great masquerade

Layland, Jamie, Jellis, Christine, Doyle, Joseph, Fox, Patricia and Wilson, Andrew (2008) Abiotrophia endocarditis: The great masquerade. Australian and New Zealand Journal of Psychiatry, 42 11: 992-993. doi:10.1080/00048670802415418


Author Layland, Jamie
Jellis, Christine
Doyle, Joseph
Fox, Patricia
Wilson, Andrew
Title Abiotrophia endocarditis: The great masquerade
Journal name Australian and New Zealand Journal of Psychiatry   Check publisher's open access policy
ISSN 0004-8674
1440-1614
Publication date 2008-01-01
Sub-type Letter to editor, brief commentary or brief communication
DOI 10.1080/00048670802415418
Open Access Status Not Open Access
Volume 42
Issue 11
Start page 992
End page 993
Total pages 2
Place of publication London, United Kingdom
Publisher Informa Healthcare
Language eng
Subject 11 Medical and Health Sciences
1109 Neurosciences
Abstract Intro: A 67-year-old man presented to St Vincent's Hospital, Melbourne, with increasing fatigue, poor concentration, anhedonia and increasing tearfulness. The patient also reported a loss of appetite, dyspnoea and significant weight loss of 10kg over the prior 6months. He had a previous history of mitral valve prolapse and bicuspid aortic valve disease that was under regular review by his physician and had recently been diagnosed with atrial fibrillation. He denied any history of fever, night sweats or arthralgia. On examination he was cachectic with evidence of a depressed affect and would frequently and unpredictably burst into tears during consultations. A psychiatric evaluation felt that the sudden and frequent bouts of emotional lability suggested the possibility of an underlying organic cause. Conclusion: This case highlights the diversity in presentation of endocarditis and that it should always be considered as a differential diagnosis in any patient who presents with initially unclear diagnostic features with pre-existing valvular disease. In this particular patient a presentation with depressed affect and weight loss without significant features of active infection predominated. The diagnosis was only established because blood cultures were collected, and those results directed further investigations for endocarditis. In patients with atypical neuropsychiatric presentations, careful clinical assessment is warranted to exclude organic disease.
Keyword Fatigue detection
Poor concentration
Anhedonia
Tearfulness
Appetitie loss
Weight loss
Dyspnoea
Mitral valve prolapse
bicuspid aortic valve disease
Endocarditis
Q-Index Code CX
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Letter to editor, brief commentary or brief communication
Collections: Faculty of Health and Behavioural Sciences -- Publications
Excellence in Research Australia (ERA) - Collection
 
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Created: Wed, 06 Jan 2010, 01:22:44 EST by Rosalind Blair on behalf of Faculty Of Health Sciences