Instituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brasil.
Instituto Nacional de Infectologia Evandro Chagas - Centro Hospitalar, Rio de Janeiro, RJ - Brasil.
Arq Bras Cardiol. 2020 Dec;115(6):1201-1204. doi: 10.36660/abc.20200206.
We present a case report of a patient with an infected mitral valve myxoma and a literature review on the subject. A 33-year-old female presented with a history of fever and dyspnea evolving over a few days. On admission, she had a lupus-like syndrome with positive blood cultures for Haemophilus species . Echocardiogram revealed a giant mass involving both mitral leaflets causing severe regurgitation, requiring biological mitral valve replacement. Microscopy showed an infected myxoma and the patient was discharged asymptomatic upon completion of antibiotics. She did well on follow-up. This is the sixth case of an infected mitral valve myxoma reported in the literature and the third case of a cardiac myxoma infected by the HACEK group. Exceedingly high incidence of embolic events makes prompt imaging, antibiotic therapy and surgery crucial for better outcomes. Time to diagnosis was much briefer than usually reported in other cases of HACEK endocarditis. Valve replacement was the most common surgical procedure and all patients from previous reports did well on follow-up.
我们报告了一例感染性二尖瓣粘液瘤患者，并对该主题进行了文献回顾。一名 33 岁女性因发热和呼吸困难病史数天入院。入院时，她出现狼疮样综合征，血培养阳性为嗜血杆菌属。超声心动图显示一个巨大的肿块累及二尖瓣的两个瓣叶，导致严重反流，需要生物二尖瓣置换。显微镜检查显示感染性粘液瘤，患者在完成抗生素治疗后无症状出院。她在随访中情况良好。这是文献中报道的第六例感染性二尖瓣粘液瘤病例，也是 HACEK 组感染的心脏粘液瘤的第三例。栓塞事件的极高发生率使得及时进行影像学检查、抗生素治疗和手术对于获得更好的结果至关重要。诊断时间明显短于其他 HACEK 心内膜炎病例通常报告的时间。瓣膜置换是最常见的手术，以前所有报告的患者在随访中情况良好。
