Adamira Marek, Justik Petr, Ulman Jaroslav, Brezina Ales, Mirejovsky Tomas, Trnkova Marketa
Department of Cardiology, Institute for Clinical & Experimental Medicine, Prague 140 00, Czech Republic.
Tex Heart Inst J. 2011;38(2):191-3.
Infected cardiac myxoma is a rare cause of endocarditis. The finding of coexisting infected cardiac myxomas is highly unusual. Herein, we present the case of a 58-year-old woman with a low-grade fever. Laboratory findings strongly indicated inflammation, and blood cultures detected Staphylococcus species. Echocardiograms revealed mobile masses in the area of the mitral valve. Transesophageal echocardiograms showed 2 formations that arose from opposite sides of the mitral annulus and protruded into the left ventricle during systole. During emergency surgery, 2 abnormal growths with numerous vegetations were completely excised. The diagnosis of myxoma was confirmed upon histologic evaluation. Microbiological and polymerase chain reaction analysis of the myxomas detected the bacterial strain Enterococcus faecalis. Five months postoperatively, the patient showed no signs of recurrent infection and had a normal echocardiographic appearance.This report is the first of an infected cardiac myxoma in the Czech population and one of approximately 60 reports in the medical literature from 1956 to the present. In addition to the case of our patient, we discuss the discrepancy between the bacteriologic findings.
感染性心脏黏液瘤是心内膜炎的罕见病因。发现并存感染性心脏黏液瘤极为罕见。在此,我们报告一例58岁低热女性病例。实验室检查结果强烈提示炎症,血培养检测到葡萄球菌属。超声心动图显示二尖瓣区域有活动肿物。经食管超声心动图显示2个肿物从二尖瓣环相对侧长出,收缩期凸入左心室。急诊手术时,2个有大量赘生物的异常肿物被完整切除。组织学评估确诊为黏液瘤。黏液瘤的微生物学和聚合酶链反应分析检测到粪肠球菌菌株。术后5个月,患者无复发感染迹象,超声心动图表现正常。本报告是捷克人群中首例感染性心脏黏液瘤病例,也是1956年至今医学文献中约60例报告之一。除了我们患者的病例,我们还讨论了细菌学检查结果之间的差异。