Manns M, Haist A, Mohr-Kahaly S, Erbel R, von Olshausen K, Staritz M, Wanitschke R, Oelert H, Meyer zum Büschenfelde K H
Dtsch Med Wochenschr. 1986 Jul 11;111(28-29):1106-9. doi: 10.1055/s-2008-1068591.
Cholecystectomy had been performed in a 52-year-old woman because of upper abdominal pain with nausea, fever and accelerated ESR and known cholelithiasis. Attacks of fever up to 39.5 degrees C persisted and she lost 10 kg in weight, requiring re-admission after eight months. Transoesophageal echocardiography revealed an echo-dense space-occupying lesion, 3.0 X 3.5 cm, in the right atrium. Due to contrast medium allergy angiography was omitted. M-mode and 2D echocardiography and computed tomography of the heart failed to demonstrate any space-occupying body. Thoracotomy revealed a fibro-angio-myxoma attached to the right side of the interatrial septum, and it was removed in toto. The postoperative course was without complications and the patient left hospital free of symptoms. It is suggested that transoesophageal echocardiography should be considered in case of "fever of unknown origin".
