Right-Side Infective Endocarditis Mimicking A Ventricular Myxoma

A 39 years old man was admitted with recurrent high fever, lost of appetite and weakness for three months. He had no history of congenital heart defect, intravenous drug use or central venous line insertion. Transesophageal echocardiographic examination established a right ventricular mass sized 32x13 mm that localized to apex and showed first degree pulmonary insufficiency. Diagnosis of cardiac myxoma was made and than mass was removed by surgically. Pathologic examination of the mass revealed suppurative inflammation that involving endocardium and myocardium with no evidence of myxoma. In addition Staphylococcus epidermidis was obtained repeatedly blood cultures. A diagnosis infective endocarditis was made on the basis of histopathologic findings and positive blood culture results. The patient was treated successfully by antimicrobial treatment (vancomycin plus gentamycin plus for 6 weeks) with surgery.

Ventriküler Miksomayý Taklit Eden Sað Kalp Enfektif Endokarditi

Otuz dokuz yaþýndaki erkek hasta üç aydýr tekrarlayan yüksek ateþ, iþtahsýzlýk ve halsizlik þikayetleri nedeniyle hastanemize yatýrýldý. Týbbi özgeçmiþinde konjenital kalp hastalýðý, intravenöz madde baðýmlýlýðý veya damar içi giriþim gibi bir risk faktörü yoktu. Transözafagial ekokardiografide sað ventrikül apeksinde lokalize 32x13 mm boyutlarýnda kitle ve birinci derecede pulmoner yetmezlik saptandý. Kardiyak miksoma tanýsý konularak kitle cerrahi olarak çýkarýldý. Kitlenin patolojik incelemesinde endokardiyum ve miyokardiyumu tutan süpüratif inflamasyon bulgularý saptandý buna karþýn miksoma ile iliþkili patolojik bulguya rastlanmadý. Tekrarlayan kan kültürlerinde Staphylococcus epidermidis izole edildi. Histopatolojik ve kan kültürü pozitifliði sonuçlarýyla enfektif endokardit tanýsý konuldu. Hasta cerrahi ve antimikrobiyal (vankomisin ve gentamisin) kombinasyonuyla baþarýlý bir þekilde tedavi edildi.