Vitiligo as a possible manifestation of infective endocarditis complicated with ischemic stroke: A case report

We report a case of young stroke sequel to sub-acute infective endocarditis with simultaneous occurrence of vitiligo. Since the early days of medical practice, identifying peripheral stigmata of infective endocarditis was highlighted as a way of early diagnosis of infective endocarditis. The literature describes several cutaneous manifestations of infective endocarditis. This is possibly the first that reports an association between vitiligo with infective endocarditis and stroke.

The patient was a thirty-four-year-old previously well female who had an intermittent fever for one month with a gradual development of vitiligo involving both hands, feet, and lips. She presented with the development of a left-sided ischaemic stroke one month after the onset of fever. She was diagnosed with having mitral valve infective endocarditis and underwent a six-week course of intravenous antibiotics until regression of the mitral valve vegetation.

Vitiligo may occur possibly as an immunological phenomenon of infective endocarditis.  Additionally, it may correlate with the occurrence of ischaemic stroke in patients with infective endocarditis.