Pintor E, Gómez C, González J, Fernández-Cruz A, Almería C, Zamorano J
Servicio de Medicina Interna III, Hospital Universitario San Carlos, Madrid.
Rev Esp Cardiol. 1998 Feb;51(2):158-60. doi: 10.1016/s0300-8932(98)74726-8.
A male heroin abuser was admitted because of Candida endophthalmitis. A permanent central venous line was inserted. Three months later, he had positive catheter and blood cultures with Staphylococcus aureus. Transthoracic and transesophageal echocardiography and magnetic resonance revealed a right atrial mass. Treatment with antibiotics in addition to clinical and echocardiographic follow up was decided upon. Six weeks later, a transesophageal echocardiography showed a decrease in right atrial mass size and the patient was discharged asymptomatic without treatment. Three months later, he was well and a new transesophageal echocardiography showed a further decrease in atrial mass size with signs of fibrosis. This follow up supports the clinical suspicion of thrombus in the right atrium attributable to a central venous line and Staphylococcus aureus bacteremia.