Thrombotic thrombocytopenic purpura (TTP) is a serious multisystem disorder that is usually rapidly progressive and often fatal if not diagnosed or treated. Unfortunately, the clinical and laboratory features of TTP are not specific and can also be seen in both autoimmune and infectious diseases. We describe a case where the rapid institution of therapy for a TTP-like syndrome masked a culture-negative infectious endocarditis. The diagnosis of this unique patient was established at valvulotomy, necessitated by acute aortic insufficiency.
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