Infective endocarditis is a serious disease associated with a high mortality. The initial presentation may be non-specific and misleading, thus delaying correct diagnosis. In this case report, we describe a 46-year-old woman, who presented with symptoms suggestive of systemic lupus erythematosus, including malar rash, arthritis, acute renal failure and thrombocytopenia, but she was subsequently proven to have infective endocarditis involving the mitral valve. Her rheumatological symptoms diminished after antibiotic therapy and mitral valve surgery.
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