# An Unusual Case of Cryoglobulinemic Vasculitis and Acute Disseminating Encephalomyelitis in a 21-Year-Old Caucasian Male

## TL;DR

A 21-year-old man with a rare combination of cryoglobulinemic vasculitis, ADEM, and infective endocarditis is reported, highlighting diagnostic challenges.

## Contribution

This case report highlights the rare co-occurrence of cryoglobulinemic vasculitis, ADEM, and infective endocarditis, emphasizing diagnostic difficulties.

## Key findings

- The patient had splenic laceration and was found to have infective endocarditis.
- Cryoglobulinemic vasculitis and ADEM were also present in the patient.
- Antibiotic use led to negative blood cultures, complicating endocarditis diagnosis.

## Abstract

Cryoglobulinemic vasculitis and acute disseminated encephalomyelitis (ADEM) are characterized by damage to either blood vessels or grey matter. For both diseases, infections can be an etiology. In cryoglobulinemic vasculitis, the initial insult causes damage to the glomerulus, and in the case of ADEM, damage leads to a central nervous system demyelinating disorder. Infective endocarditis can be associated with both diseases and can be challenging to diagnose. Individuals on antibiotics may present with negative blood cultures, making underlying infective endocarditis difficult to diagnose. In this report, we describe a 21-year-old male who presented to the hospital after an assault with splenic laceration and was subsequently found to have infective endocarditis associated with cryoglobulinemic vasculitis and ADEM.