Giant Vegetation in the Right Ventricle Caused by <i>Staphylococcus aureus</i> and <i>Candida mycoderma</i>
DOI:
https://doi.org/10.1532/HSF98.2013252Abstract
Introduction: Infective endocarditis (IE) is considered a multifactorial disease. Providing an early diagnosis and invasive treatment together with effective antibiotic treatment remain critical tasks for the cardiologist and the surgeon. Right ventricular endocarditis is a rare type of endocarditis usually caused by Staphylococcus aureus and Candida mycoderma.
Case Presentation: We present a 25-year-old male patient who presented with persistent malaise, fever, cough, and anorexia after 55 days of antibiotic treatment. Lung computed tomographic scanning excluded severe lung infection. Transthoracic and transesophageal echocardiography revealed a giant vegetation in the right ventricle. Blood culture was positive for S. aureus and C. mycoderma, and antibiotic therapy was immediately applied. Considering the large burden of infected tissue, an early surgical intervention was planned. The cultures of the vegetation specimen were negative. Intraoperative and histological findings confirmed the echocardiographic diagnosis of IE.
Conclusions: Giant vegetations in the right ventricle caused by S. aureus and C. mycoderma are rare. In addition to medical treatment, more attention should be paid to early surgical consultation.
References
Cabell CH, Abrutyn E. 2003. Progress toward a global understanding of infective endocarditis. Lessons from the International Collaboration on Endocarditis. Cardiol Clin 21:147-58. Erratum in Cardiol Clin 21:483.nHorstkotte D, Follath F, Gutschik E, et al. 2004. Guidelines on prevention, diagnosis and treatment of infective endocarditis executive summary; the task force on infective endocarditis of the European Society of Cardiology. Eur Heart J 25:267-76.nKarchmer AW. Infections on prosthetic valves and intravascular devices. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett's principles and practice of infectious diseases. Philadelphia: Churchill Livingstone; 2000. p 903-17.nLytle BW. 1995. Prosthetic valve endocarditis. Thorac Cardiovasc Surg 7:1.nMiro JM, del Rio A, Mestres CA. 2003. Infective endocarditis and cardiac surgery in intravenous drug abusers and HIV-1 infected patients. Cardiol Clin 21:167-84, v-vinMoreillon P, Que YA. 2004. Infective endocarditis. Lancet 363:139-49.nMusci M, Siniawski H, Pasic M, et al. Surgical treatment of right-sided active infective endocarditis with or without involvement of the left heart: 20-year single center experience. Eur J Cardiothorac Surg 32:118-25.nMylonakis E, Calderwood SB. 2001. Infective endocarditis in adults. N Engl J Med 345:1318-30.nRubinstein E, Lang R. 1995. Fungal endocarditis. Eur Heart J 16(Suppl B):84-9.n
