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Mural vegetation in left ventricular apex caused by Staphylococcus aureus
Takeshi Uzuka1, Masanori Nakamura1, Mayo Kondo1
1Department of Cardiovascular Surgery, Sapporo City General Hospital, Sapporo, Hokkaido, Japan.
Interactive Cardiovascular and Thoracic Surgery
|November 18, 2020
Summary
A rare case of infective endocarditis presented with stroke and fever in a haemodialysis patient. A mobile, spherical vegetation was found attached to the left ventricle apex, a highly unusual finding.
Area of Science:
- Cardiology
- Infectious Diseases
- Nephrology
Background:
- Infective endocarditis (IE) is a serious infection affecting heart valves or endocardium.
- Patients with chronic kidney disease on haemodialysis have an increased risk of IE.
- Staphylococcus aureus is a common pathogen in IE, particularly in haemodialysis patients.
Observation:
- A 77-year-old male on chronic haemodialysis presented with recurrent stroke and fever.
- Blood cultures identified Staphylococcus aureus.
- Echocardiography revealed moderate mitral regurgitation, left atrial appendage masses, and a unique 20-mm mobile, spherical structure at the left ventricle apex.
Findings:
- Surgical excision of the cardiac masses was performed.
- Pathological examination confirmed infective endocarditis.
- The presence of a mobile, spherical vegetation attached to the left ventricle apex is a rare clinical manifestation of IE.
Implications:
- This case highlights the diverse presentations of infective endocarditis.
- Early diagnosis and surgical intervention are crucial for favorable outcomes in complex IE cases.
- The findings underscore the importance of considering IE in haemodialysis patients with neurological symptoms and fever.
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