A case of nonvalvular endocarditis with biventricular apical infected thrombi.
Anish VaniCarolyn Y HoRobert DonninoAlbert JungMikhail VaynblatLarry LatsonMuhamed SaricPublished in: Echocardiography (Mount Kisco, N.Y.) (2020)
We report what appears to be the first case of biopsy-proven nonvalvular endocarditis with biventricular apical infected thrombi. A 47-year-old man presented with hypoxic respiratory failure from a multilobar pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA). Transthoracic echocardiography and cardiac magnetic resonance imaging revealed biventricular apical masses suggestive of nonvalvular endocarditis with infected thrombi. Given concern for ongoing septic embolization to the lungs and brain despite appropriate antimicrobial therapy, the masses were surgically resected. Culture and histopathology confirmed MRSA-positive infected thrombi. In this case report, we highlight the differential diagnosis of apical masses and the role of multimodality imaging.
Keyphrases
- methicillin resistant staphylococcus aureus
- staphylococcus aureus
- respiratory failure
- atrial fibrillation
- magnetic resonance imaging
- fine needle aspiration
- contrast enhanced
- ultrasound guided
- case report
- left ventricular
- cardiac resynchronization therapy
- computed tomography
- left atrial appendage
- direct oral anticoagulants
- extracorporeal membrane oxygenation
- heart failure
- high resolution
- lymph node
- contrast enhanced ultrasound
- stem cells
- single cell
- magnetic resonance
- intensive care unit
- mass spectrometry
- subarachnoid hemorrhage
- brain injury
- community acquired pneumonia