Non-bacterial thrombotic

Non-bacterial thrombotic or marantic endocarditis Rheumatic disease Prosthetic valve Calcification and/or sclerosis... 

Thrombotic thrombocytopenic purpura is a rare acute or subacute disease in adults, rather similar to the hemolytic uremic syndrome in children, in which there is systemic malaise, fever, skin purpura, renal failure, hematuria and proteinuria. Hemorrhagic infarcts caused by platelet microthrombi occur in many organs in the brain they may cause stroke-like episodes (Matijevic and Wu 2006) although more commonly there is global encephalopathy. The blood film shows thrombocytopenia, hemolytic anemia and fragmented red cells. The differential diagnosis includes infective endocarditis, idiopathic thrombocytopenia, heparin-induced thrombocytopenia with thrombosis, systemic lupus erythematosus, non-bacterial thrombotic endocarditis and disseminated intravascular coagulation. 

When increased coagulability develops in patients with nonspecific valvular deformities (focal or diffuse), nonbacterial thrombotic endocarditis develops. Non-bacterial can be distinguished from bacterial endocarditis on the basis of negative blood cultures and the presence of multiple emboli in spleen, kidney, and brain. 

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