{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T22:44:03Z","timestamp":1777329843308,"version":"3.51.4"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cardiovascular involvement is frequent in systemic lupus erythematosus (SLE). Valvular abnormalities are increasingly being recognized with the advent of echocardiography.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We present a case of a 46-year-old lady who presented to the emergency department with upper limb ischaemia. On examination, she had poor dentition and a short systolic murmur on auscultation. A blood workup revealed a diagnosis of SLE. Further investigations showed vegetations on the mitral valve. Initially, an infective endocarditis (IE) diagnosis was made, which was treated with antibiotics. High-dose steroids and immunosuppressants were initiated due to her clinical deterioration and biopsy-proven lupus nephritis. She improved clinically before being discharged home.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>It can be difficult to distinguish between IE and Libman\u2013Sacks endocarditis (LSE), especially in the setting of risk factors for both. Antibiotics and immunosuppressants might be started simultaneously in these cases. A multidisciplinary team is required to manage challenging cases of culture-negative endocarditis. Procalcitonin may have a role in differentiating bacterial endocarditis and LSE.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad290","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T13:52:03Z","timestamp":1688737923000},"source":"Crossref","is-referenced-by-count":2,"title":["Case report of culture-negative endocarditis in lupus nephritis"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8774-5229","authenticated-orcid":false,"given":"Harshwardhan","family":"Khandait","sequence":"first","affiliation":[{"name":"Trinitas Regional Medical Center, RWJ Barnabas Health , 225 Williamson St, Elizabeth 07202, NJ , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng Ken","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Russells Hall Hospital, Dudley Group NHS Foundation Trust , Dudley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayesha","family":"Javaid","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Russells Hall Hospital, Dudley Group NHS Foundation Trust , Dudley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rav","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust , Dudley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,7,7]]},"reference":[{"key":"2023071411051035000_ytad290-B1","doi-asserted-by":"crossref","volume-title":"Dubois\u2019 Lupus Erythematosus","author":"Wallace","DOI":"10.7326\/0003-4819-109-5-436_2"},{"key":"2023071411051035000_ytad290-B2","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1056\/NEJM198809293191302","article-title":"Prevalence, morphologic types, and evolution of cardiac valvular disease in 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