Nonbacterial thrombotic endocarditis associated with bone marrow transplantation.

Two patients were treated with bone marrow transplantation and subsequently developed nonbacterial thrombotic endocarditis (NBTE). Both patients died of embolic sequellae and in neither was NBTE suspected antefinem. It is clear that NBTE occurs with increased frequency in bone marrow transplant (BMT) recipients and through arterial embolization contributes significantly to the morbidity and mortality of this procedure. In those at greatest risk, including BMT recipients, detection of disseminated intravascular coagulation; soft, changing systolic cardiac murmurs; hematuria; and signs of central embolic events suggest the diagnosis of NBTE. Awareness of the diagnosis of NBTE is essential for those who must interpret neurologic, myocardial and renal abnormalities in BMT recipients.