Shimizu K, Tabuchi N, Sakamoto T, Suzuki A, Iizumi T
Department of Cardiothoracic Surgery, Tokyo Medical and Dental University, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Dec;40(12):2236-40.
A 22-year-old man had undergone dental therapy following an intermittent fever, and the bacteriological examination by blood culture identified Streptococcus viridans. A left atrial myxoma was echocardiographically found out and the tumor was surgically resected with uneventful postoperative course. Multiple foci and Gram-positive cocci within the typical myxoma were revealed histopathologically. Reviewing previous reports on infected cardiac myxoma, the coexistence of cardiac myxoma and a confirmed positive blood culture has been considered diagnostic criteria for "infected cardiac myxoma". But, from the surgical viewpoint, the demonstration of infecting organisms within the tumor is essential for accurate diagnosis. Infected atrial myxoma has an extremely high incidence of systemic embolization, and its bacterial foci could be the source of persistent bacteremia. Therefore, in clinical situations suggesting infected cardiac myxoma, we recommend performing open heart surgery to prevent both the embolization and the infective progression into other cardiac valves, as soon as possible.
