Sepsis complicating giant cardiac myxoma

Myxomas, as other primary cardiac tumors, appear rarely. The most common symptoms are typical of mitral stenosis or peripheral embolism. The rarity of infected cardiac myxomas leads to numerous diagnostic and therapeutic difficulties. We present a case of a 67-year-old man with fever of unknown origin. Laboratory results disclosed signs of sepsis, disseminated intravascular coagulation, acute renal failure, and neuroinfection. Blood cultures were positive for methicillin-resistant Staphylococcus aureus. Transthoracic echocardiogram revealed enlarged left atrium filled with tumor with mobile structure protruding into the left ventricle during diastole. Abnormal intra-atrial mass were also apparent in chest computed tomography (CT). Because of sepsis complicated by coagulation disorders, surgical treatment was postponed. On the 11th day, a large retroperitoneal hematoma occurred, and it was punctured under ultrasonography (USG) control. After 37 days of intensive medical therapy, a stable patient was operated. A giant tumor fixed to the atrial wall between the pulmonary veins' orifices was excised and confirmed as myxoma in histological tests. The patient was discharged in good condition and was followed up for several months with no further complications.