Mononeuritis Multiplex as the Initial Manifestation of Candida Infective Endocarditis

Ki Seong Eom

doi:10.4184/jkss.2016.23.3.166

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Eom: Mononeuritis Multiplex as the Initial Manifestation of Candida Infective Endocarditis

Case Report

Journal of Korean Spine Surg 2016;23(3):166-170.

Published online: 30 September 2016

DOI: https://doi.org/10.4184/jkss.2016.23.3.166

Mononeuritis Multiplex as the Initial Manifestation of Candida Infective Endocarditis

Ki Seong Eom, M.D., Ph.D.

Department of Neurosurgery, Wonkwang University School of Medicine, Iksan, Korea

Corresponding author: Ki Seong Eom, M.D., Ph.D. Department of Neurosurgery, Wonkwang University Hospital, 344-2 Shinyong-dong, Iksan Jeon Buk 570-711, Korea TEL: +82-63-859-1467, FAX: +82-63-852-2606 E-mail: kseom@wonkwang.ac.kr

Received 15 February 201617 February 2016 Accepted 7 April 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Case report.

Objectives

To report a case of mononeuritis multiplex as the initial manifestation of Candida infective endocarditis (IE).

Summary of Literature Review

Mononeuritis multiplex is actually a group of diseases, not a distinct disease entity. It often results from blood vessel diseases, diabetes, or inflammation due to autoimmune connective tissue disorders, although many cases are idiopathic. IE is an infection of the endocardial surface of the heart. Multiple nerves were affected simultaneously in several cases of IE, making consideration of IE important in the differential diagnosis of mononeuritis multiplex.

Materials and Methods

We present a rare case of a 71-year-old man with IE in whom mononeuritis multiplex was revealed on electromyography; further, he presented with lower back pain and sciatica.

Results

The presence of the characteristic symptoms of lumbar radiculopathy in this case delayed the diagnosis and proper treatment of the patient.

Conclusions

Physicians should carefully consider all patient-related data, and also provide accurate information to consultants when they refer patients. This can help to prevent serious complications.

Keywords: Mononeuritis multiplex, Infective endocarditis, Lumbar radiculopathy

REFERENCES

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Fig. 1.

Gadolinium-enhanced sagittal magnetic resonance imaging (A, B) showing no significant abnormality to explain the pyogenic spondylitis.

Fig. 2.

Transthoracic echocardiogram showing vegetation on the aortic valve (24 � 18 mm) and moderate aortic stenosis with mild aortic regurgi-tation due to vegetation: highly suggestive of infectious endocarditis. AV = aortic valve; LA = left atrium; LV = left ventricle, MV = mitral valve; RA = right ventricle.

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