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A 61 years-old woman treated with methylprednisolone due to arthritis mutilans was admitted to our hospital after being found to have complete atrioventricular block and vegetation on the mitral and aortic valves. Infective endocarditis was suspected, but offending bacteria was not detected by repetitive blood cultures. Despite intensive care, we could not control the infection and she died of complication of acute respiratory distress syndrome on the eleventh day. Autopsy findings revealeddoi:10.4172/2329-9126.1000160 fatcat:umyxnuv7szc6lnhx42mdgwlhme