Coughlin W F, Knott P E
Department of Radiology, Tripler Army Medical Center, Honolulu, Hawaii 96859-5000.
J Adolesc Health Care. 1990 Jul;11(4):351-4. doi: 10.1016/0197-0070(90)90047-6.
An adolescent girl presented with fever, headache, and mental status changes. Blood cultures 12 hours after admission were positive for Staphylococcus aureus. The initial evaluation did not reveal a source of the patient's sepsis. Forty-eight hours after admission a cardiac ejection click was detected. The chest radiograph showed ill-defined opacities compatible with pulmonary emboli in the right lung and a calcific density in the region of the right atrium. Echocardiogram confirmed the presence of a right atrial mass, which at surgery and upon histologic examination was a myxoma. Atrial myxomas are rare tumors in adolescents but should be considered in the differential diagnosis of suspected septic pulmonary emboli.
一名青春期女孩出现发热、头痛和精神状态改变。入院12小时后的血培养结果显示金黄色葡萄球菌呈阳性。初步评估未发现该患者败血症的来源。入院48小时后检测到心脏喷射喀喇音。胸部X线片显示右肺有与肺栓塞相符的边界不清的模糊影以及右心房区域的钙化密度影。超声心动图证实右心房有肿物，手术及组织学检查显示为黏液瘤。心房黏液瘤在青少年中是罕见肿瘤，但在疑似感染性肺栓塞的鉴别诊断中应予以考虑。
