Baratella Maria Cristina, Calamelli Sara, Candiotto Marco, D'Este Daniele
G Ital Cardiol (Rome). 2013 Dec;14(12):833-5. doi: 10.1714/1371.15240.
We report the case of a 45-year-old man addicted to intravenous drug abuse who was admitted to our hospital for dyspnea, fever and chest pain. Chest X-ray showed diffuse right lung opacity and pleural effusion. Transthoracic echocardiography and contrast-enhanced cardiac magnetic resonance imaging revealed a plurilobated, highly mobile mass in the right ventricle originating from the moderator band near the apical trabeculae. Cardiac structure and valves were normal. Blood cultures were positive for Staphylococcus hominis. The diagnosis of infective endocarditis with mural vegetation was made. Specific antibiotic therapy was started with success and after 3 weeks the mass disappeared. Infective endocarditis with mural vegetation in the absence of valvular lesions is uncommon. Differential diagnosis is always required, but clinical course should be our guide in decision making.
我们报告了一例45岁静脉注射吸毒成瘾男性患者，因呼吸困难、发热和胸痛入院。胸部X线显示右肺弥漫性模糊影及胸腔积液。经胸超声心动图和对比增强心脏磁共振成像显示右心室有一个多叶状、高度活动的肿块，起源于近心尖小梁的节制索。心脏结构和瓣膜正常。血培养结果为人型葡萄球菌阳性。诊断为感染性心内膜炎伴壁性赘生物。开始了特异性抗生素治疗并取得成功，3周后肿块消失。无瓣膜病变的感染性心内膜炎伴壁性赘生物并不常见。始终需要进行鉴别诊断，但临床病程应作为我们决策的指导。
