A patient with HACEK organism endocarditis (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella) develops large vegetations with septic emboli. Libman-Sacks endocarditis differs from infective endocarditis in that it:
- A Shows small sterile vegetations on both surfaces of mitral valve leaflets associated with SLE and antiphospholipid syndrome ✓
- B Involves only the tricuspid valve, sparing left-sided valves
- C Is caused by non-bacterial thrombotic endocarditis in hypercoagulable states with large friable sterile vegetations
- D Is rheumatic endocarditis specifically involving the line of valve closure
Correct answer: A. Shows small sterile vegetations on both surfaces of mitral valve leaflets associated with SLE and antiphospholipid syndrome
Explanation
Libman-Sacks endocarditis is a non-infectious endocarditis associated with systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome. It is characterized by small (1-4 mm), sterile, warty vegetations on both surfaces (including undersurface) of the mitral valve, unlike infective endocarditis (large, irregular, on atrial surface of AV valves) and rheumatic endocarditis (small beads along line of closure). Non-bacterial thrombotic (marantic) endocarditis shows sterile vegetations in wasting states (malignancy, sepsis) along the line of closure.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.