Gonococcal Endocarditis With Penicillin-Induced Bone Marrow Hypoplasia

Abstract

ENDOCARDITIS is a rare complication of gonococcal infection.¹We describe an unusual case in which treatment was complicated by two severe episodes of drug-induced neutropenia. This report emphasizes the important role of echocardiography in the diagnosis and management of endocarditis. <h3>Report of a Case</h3> An 18-year-old woman was admitted with a three-week history of fever, chest pain, and painful swellings on the left index finger and thumb. One week previously, her right knee had been swollen and painful. Her temperature was 38 °C, splinter hemorrhages were noted, and Osler's nodes were present on the left index finger and thumb. The carotid pulse was regular with a sharp upstroke. The blood pressure was 150/60 mm Hg. There were no signs of heart failure. An ejection systolic murmur and a loud early diastolic murmur were audible over the precordium. The ECG showed sinus rhythm and widespread nonspecific T-wave flattening. The chest