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Case Reports
. 2011;38(2):191-3.

Two sporadic infected cardiac myxomas in 1 patient

Marek Adamira  1 , Petr Justik, Jaroslav Ulman, Ales Brezina, Tomas Mirejovsky, Marketa Trnkova
Affiliations
Case Reports

Two sporadic infected cardiac myxomas in 1 patient

Marek Adamira et al. Tex Heart Inst J. 2011.

Abstract

Infected cardiac myxoma is a rare cause of endocarditis. The finding of coexisting infected cardiac myxomas is highly unusual. Herein, we present the case of a 58-year-old woman with a low-grade fever. Laboratory findings strongly indicated inflammation, and blood cultures detected Staphylococcus species. Echocardiograms revealed mobile masses in the area of the mitral valve. Transesophageal echocardiograms showed 2 formations that arose from opposite sides of the mitral annulus and protruded into the left ventricle during systole. During emergency surgery, 2 abnormal growths with numerous vegetations were completely excised. The diagnosis of myxoma was confirmed upon histologic evaluation. Microbiological and polymerase chain reaction analysis of the myxomas detected the bacterial strain Enterococcus faecalis. Five months postoperatively, the patient showed no signs of recurrent infection and had a normal echocardiographic appearance.This report is the first of an infected cardiac myxoma in the Czech population and one of approximately 60 reports in the medical literature from 1956 to the present. In addition to the case of our patient, we discuss the discrepancy between the bacteriologic findings.

Keywords: Bacteroidaceaeinfections/complications/diagnosis/drug therapy; echocardiography; heart atria/pathology; heart neoplasms/diagnosis/surgery; heart valve diseases/surgery; myxoma/diagnosis/pathology/surgery; neoplasms, second primary; treatment outcome.

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Figures

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Fig. 1 Transesophageal echocardiography shows 2 formations that arise from opposite sides of the mitral annulus (MA) and protrude into the left ventricle (LV) during diastole. LA = left atrium; MX = myxoma
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Fig. 2 Photomicrograph shows myxomatous tissue with endocarditis-related vegetation and thrombus composed of fibrin with neutrophils and macrophages (H & E, orig. ×50).
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Fig. 3 Photomicrograph is positive for calretinin in the myxomatous cells (H & E, orig. ×200).
See this image and copyright information in PMC

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