ABSTRACT
Resumen: Se presenta el caso de un hombre de 61 años, portador de un cáncer pulmonar en quien lesiones de aspecto embólico llevan al diagnóstico de Endocarditis marántica (no infecciosa). Se describen las características clínicas del paciente, los métodos diagnósticos incluyendo imágenes ecocardiográficas y la confirmación necrópsica.
Abstracts: A 61-year-old male with skin lesions suggesting embolic phenomena, was thoroughly investigated and a final diagnosis of marantic (non-infectious) endocarditis was established. Clinical characteristics and diagnostic investigation through laboratory test and images sustained the diagnosis. The use of transesophageal echocardiography is emphasized. This was finally confirmed by findings at necropsy.
Subject(s)
Humans , Male , Middle Aged , Adenocarcinoma, Papillary/complications , Endocarditis, Non-Infective/etiology , Endocarditis, Non-Infective/diagnostic imaging , Lung Neoplasms/complications , Magnetic Resonance Imaging , Adenocarcinoma, Papillary/diagnostic imaging , Tomography, X-Ray Computed , Fatal Outcome , Echocardiography, Transesophageal , Embolism/etiology , Lung Neoplasms/diagnostic imagingABSTRACT
Marantic or nonbacterial thrombotic endocarditis is characterized for the presence of vegetations formed by a meshwork of fibrin and other cellular material similar a blood clot, without the presence of microorganisms. It is often related with tumors and chronic inflammatory states. We report a 49 years old female with a history of weight loss and asthenia, presenting with multiple cerebrovascular attacks and fever. Blood cultures were negative and the fever did not subside with antibiotic treatment. Trans esophageal echocardiogram showed a mitral valve vegetation and thickening of the free edge of both leaflets. In search of the etiology of such a case, a primary pancreatic cancer with distant metastases was found. We cannot rule out the differential diagnosis with bacterial endocarditis with negative blood cultures, although the clinical context supports a non-infectious etiology.
Subject(s)
Humans , Female , Middle Aged , Endocarditis, Non-Infective/pathology , Endocarditis, Non-Infective/diagnostic imaging , Pancreatic Neoplasms/diagnostic imaging , Magnetic Resonance Imaging , Radiography, Thoracic , Tomography, X-Ray Computed , Fatal Outcome , Stroke/diagnostic imaging , Diagnosis, DifferentialABSTRACT
Marantic or nonbacterial thrombotic endocarditis is characterized for the presence of vegetations formed by a meshwork of fibrin and other cellular material similar a blood clot, without the presence of microorganisms. It is often related with tumors and chronic inflammatory states. We report a 49 years old female with a history of weight loss and asthenia, presenting with multiple cerebrovascular attacks and fever. Blood cultures were negative and the fever did not subside with antibiotic treatment. Trans esophageal echocardiogram showed a mitral valve vegetation and thickening of the free edge of both leaflets. In search of the etiology of such a case, a primary pancreatic cancer with distant metastases was found. We cannot rule out the differential diagnosis with bacterial endocarditis with negative blood cultures, although the clinical context supports a non-infectious etiology.