Subacute Bacterial Endocarditis Presenting with Necrotic Skin Lesions

Abstract
Classical lesions associated with subacute bacterial endocarditis include petechiae, splinter hemorrhages, Osler's modes and Janaway lesions. We describe a patient with subacute bacterial endocarditis, whose sole cutaneous findings were bullous necrotic lesions of the lower extremities. The vessels were occluded by acidophilic material and coccal bacteria were identified in the vessels. Immunofluorescent studies revealed Igm and C3 in the vessel walls.