Infected left atrial myxoma

Area of Science:

• Cardiology
• Infectious Diseases
• Pathology

Background:

• Bacterial endocarditis can present with systemic symptoms like fever and malaise.
• Left atrial myxomas are primary cardiac tumors that can cause embolic or obstructive symptoms.

Observation:

• A 40-year-old male presented with fever, weight loss, and malaise.
• Blood cultures identified Streptococcus mutans, leading to a suspicion of endocarditis.
• Echocardiography revealed a large left atrial tumor.

Findings:

• The patient received 6 weeks of penicillin treatment for suspected endocarditis.
• Surgical excision of the left atrial tumor was performed.
• Pathological examination identified the tumor as a myxoma with fibrin deposits, bacterial colonization, and significant neutrophil infiltration.

Implications:

• This case highlights the importance of considering cardiac tumors in the differential diagnosis of culture-positive endocarditis.
• Bacterial colonization of cardiac myxomas can mimic or coexist with infective endocarditis.
• Prompt diagnosis and surgical intervention are crucial for managing patients with infected cardiac myxomas.