The Importance of Trans-Esophageal Echocardiography in Diagnosing Libman-Sacks Endocarditis in Systemic Lupus Erythematosus: A Case Report

This case report emphasizes the critical role of trans-esophageal echocardiography (TEE) in diagnosing Libman-Sacks endocarditis (LSE) in patients with systemic lupus erythematosus (SLE), particularly when differentiating it from infectious endocarditis. The report details a 22-year-old male patient who presented with symptoms suggestive of infectious endocarditis but was ultimately diagnosed with LSE through TEE, which revealed characteristic valvular lesions not visible on trans-thoracic echocardiography (TTE). The findings led to a change in treatment from antibiotics to high-dose corticosteroids. The report underscores that TEE is more sensitive and specific than TTE in identifying LSE, which is crucial for guiding appropriate management and preventing cerebrovascular complications in SLE patients.