Right ventricular mural endocarditis presenting as an isolated apical mass in a non-addict patient with congenital deafness and aphasia

Abstract

Right heart infective endocarditis presenting as an isolated apical mural mass is an extremely uncommon finding. A 24-year-old woman with congenital deafness and aphasia was admitted with recurrent attacks of fever and lobar pneumonia. Her past medical history was significant for an open operation for left nephrolithiasis five months before admission. She had no history of congenital heart defect, intravenous drug use or central venous line insertion. Diagnostic workup revealed a large pedunculated solid mass attached to the apex of the right ventricle and multiple septic foci in both lungs. Repeated blood cultures were negative. In spite of aggressive antibiotic therapy, she had progressively worsening respiratory distress. She was successfully operated for the mass and the pathologic findings were consistent with endocarditis. To our knowledge, the anatomical location of the mural endocarditis (apex of right ventricle) is a pretty uncommon condition.