Right atrial myxoma. A cause of septic pulmonary emboli in an adolescent female.

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.