[Fever of long standing in atrial myxoma]

A 39-year-old man is described who presented with the unspecific signs of systemic disease (elevated erythrocyte sedimentation rate, increased gamma-globulins, positive rheumatoid factor; clubbing, splenomegaly) and with fever whose origin remained undiagnosed for 8 years despite numerous investigations. Later in the course of the disease, the signs of mitral stenosis appeared, suggesting left atrial myxoma even in the absence of arterial embolization. This diagnosis was established by echocardiography and confirmed by angiocardiography as well as at operation, after which all the systemic signs and symptoms disappeared.