Migrating Needle in Right Ventricle Wall With Purulent Tamponade

Area of Science:

• Cardiology
• Infectious Diseases
• Trauma Surgery

Background:

• Foreign body migration to the right ventricle is rare but life-threatening.
• Intravenous drug abuse presents unique diagnostic challenges.
• A case of a needle fragment in the right ventricle causing cardiac tamponade is presented.

Purpose of the Study:

• To report a rare case of a needle fragment migrating to the right ventricle.
• To highlight the diagnostic challenges and dual pathophysiology of purulent pericardial effusion with an intramyocardial foreign body.
• To emphasize the importance of patient history in diagnosing such rare complications.

Main Methods:

• Case report of a 41-year-old male with a history of intravenous drug abuse.
• Diagnostic imaging included computed tomography and transthoracic echocardiography.
• Surgical exploration and microbiological cultures were performed.

Main Results:

• A 20-mm needle fragment was found embedded in the right ventricular wall.
• Purulent pericardial effusion and cardiac tamponade were identified.
• Methicillin-sensitive Staphylococcus aureus infection was confirmed; the needle was successfully removed.

Conclusions:

• This case illustrates a rare complication of intravenous drug abuse involving intramyocardial foreign body.
• The dual pathophysiology of purulent pericardial effusion and cardiac tamponade due to an embedded needle is highlighted.
• Thorough patient anamnesis is crucial for early diagnosis due to non-specific symptoms.