PMC7086409_01
Showing the petechial rash on the anterior aspect of the lower extremity.
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There was an erythematous petechial rash with crust present on the anterior aspect of his left lower extremity (Figure 1).
This demonstrates a transesophageal echocardiogram for evaluation of endocarditis. (a): Mid esophageal view showing a large vegetation on the anterior leaflet of the mitral valve. The color doppler shows severe aortic regurgitation jet towards the anterior mitral leaftet. (b): Mid esophageal long axis view demonstrating severe mitral regurgitation. (c): Mobile echo density on the atria aspect of the mitral valve. (d): Aortic valve is found to be a bicuspid valve associated with severe aortic regurgitation.
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Ultimately, a transesophageal echocardiogram performed showed normal left ventricular systolic function and a large vegetation on the anterior leaflet of the mitral valve with associated severe aortic and mitral regurgitation (Figure 2).