{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T10:07:38Z","timestamp":1777716458959,"version":"3.51.4"},"reference-count":8,"publisher":"IMR Press","issue":"4","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Aims\/Background: Infective endocarditis (IE) is a serious and potentially life-threatening condition characterised by inflammation and infection of the endocardium. While cardiac manifestations are well-recognised, extracardiac manifestations of IE, particularly in the gastrointestinal tract, are less commonly reported. We report the first known case of IE presenting with colitis-like symptoms in the absence of identifiable colonic pathology. Case Presentation: A 34-year-old male patient presented to primary care with gastrointestinal symptoms, including fever, weight loss, and bloody diarrhoea. There was an absence of detectable intestinal pathology on colonoscopy, and subsequent findings revealed a link between the gastrointestinal symptoms and IE-related complications. The patient later developed right-sided flank pain, a pansystolic murmur, and splinter haemorrhages in two fingernails. Imaging studies indicated renal infarcts suspicious for septic emboli, and echocardiography revealed severe mitral regurgitation with an anterior leaflet vegetation. Blood cultures were negative, likely due to prior antibiotic administration. Results: The patient was therefore treated with empirical intravenous antibiotics (amoxicillin, flucloxacillin and gentamicin), resulting in the resolution of gastrointestinal symptoms. Conclusion: This case highlights the importance of considering IE in patients with unexplained gastrointestinal symptoms and systemic features, even in the absence of visible colonic lesions. Early recognition and appropriate management may improve outcomes.<\/jats:p>","DOI":"10.31083\/bjhm52972","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:17:23Z","timestamp":1777457843000},"source":"Crossref","is-referenced-by-count":0,"title":["When Infective Endocarditis Masquerades as Gastrointestinal Disease: A Case Report"],"prefix":"10.31083","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5701-1213","authenticated-orcid":true,"given":"Rachel","family":"Austin","sequence":"first","affiliation":[{"name":"Department of Cardiology, Imperial College NHS Foundation Trust, W12 0HS London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3678-1932","authenticated-orcid":true,"given":"Mohamed","family":"Zuhair","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, SW3 6LY London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nandita","family":"Kaza","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, SW3 6LY London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Keene","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, SW3 6LY London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1595-8292","authenticated-orcid":true,"given":"David","family":"Lefroy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Imperial College NHS Foundation Trust, W12 0HS London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Rajani R, Klein JL. Infective endocarditis: A contemporary update. Clinical Medicine. 2020; 20: 31\u201335.","DOI":"10.7861\/clinmed.cme.20.1.1"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Ambrosioni J, Hernandez-Meneses M, T\u00e9llez A, Peric\u00e0s J, Falces C, Tolosana JM, et al. The Changing Epidemiology of Infective Endocarditis in the Twenty-First Century. Current Infectious Disease Reports. 2017; 19: 21.","DOI":"10.1007\/s11908-017-0574-9"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, et al. 2023 ESC Guidelines for the management of endocarditis: Developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM). European Heart Journal. 2023; 44: 3948\u20134042.","DOI":"10.1093\/EURHEARTJ\/EHAD193"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Agnes A, Biondi A, Belia F, Di Giambenedetto S, Addolorato G, Antonelli M, et al. Association between colorectal cancer and Streptococcus gallolyticus subsp. pasteuranus (former S. bovis) endocarditis: clinical relevance and cues for microbiota science. Case report and review of the literature. European Review for Medical and Pharmacological Sciences. 2021; 25: 480\u2013486.","DOI":"10.26355\/eurrev_202101_24417"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Park JH, Jang HR, Lee JE, Huh W, Kim DJ, Oh HY, et al. Infective endocarditis with multiple mycotic aneurysms mimicking vasculitis: A case report. The Canadian Journal of Infectious Diseases & Medical Microbiology. 2012; 23: e67\u20138.","DOI":"10.1155\/2012\/365413"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Spindel J, Parikh I, Terry M, Cavallazzi R. Leucocytoclastic vasculitis due to acute bacterial endocarditis resolves with antibiotics. BMJ Case Reports. 2021; 14: e239961.","DOI":"10.1136\/bcr-2020-239961"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Quek E, Monkman B, Madani Y. Lessons of the month 1: Mesenteric ischaemia secondary to infective endocarditis. Clinical Medicine. 2022; 22: 282\u2013284.","DOI":"10.7861\/clinmed.2022-0044"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Zulfiqar F, Bilal M, Shah Y, Morgan S, Fatima R, Singh B, et al. Navigating mesenteric vasculitis: A comprehensive review of literature. Disease-a-Month. 2024; 70: 101830.","DOI":"10.1016\/j.disamonth.2024.101830"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/4\/10.31083\/BJHM52972","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:18:26Z","timestamp":1777457906000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/4\/10.31083\/BJHM52972"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":8,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1750-8460(26)02622-0"],"URL":"https:\/\/doi.org\/10.31083\/bjhm52972","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,16]]},"article-number":"52972"}}