Infected tricuspid valve myxoma with Kodamaea ohmeri: Case report.

A 46-year-old male was having un-resolving fever for six weeks. Trans-esophageal echocardiography showed tricuspid valve myxoma (TVM). Kodamaea ohmeri was identified in 2 blood cultures and confirmed by 28S rDNA sequencing. Over three weeks of liposomal Amphotericin-B, fever has subsided thus indicated a clinical response. Subsequent echocardiography revealed no regression of suspected vegetation, and it was removed, and TV replacement was done. Histopathology revealed an infected myxoma and K. omeri was detected following 28S rDNA sequencing. For cardiac myxoma, excision is offered while for IE prolonged use of antifungals with or without vegetectomy is offered. So proper identification is important.

A Case of Infected Left Atrial Myxoma Presenting as ST-Elevation Myocardial Infarction (STEMI).

BACKGROUND Although left atrial myxoma is the most common benign primary cardiac tumor, infected atrial myxoma is rare. This report presents a case of infected left atrial myxoma with embolization to the left anterior descending (LAD) coronary artery, which was identified following an initial presentation with ST-elevation myocardial infarction (STEMI). CASE REPORT A 34-year-old man with a history of smoking tobacco and intravenous cocaine use presented to the emergency room with symptoms of a feeling of pressure on the chest and symptoms in the left arm. An electrocardiogram (ECG) showed ST elevation in leads II, III, aVF, and V3-V5, consistent with an anterior-inferior STEMI. He underwent percutaneous intervention (PCI) with two drug-eluting stents to the mid-distal LAD coronary artery. The patient also had fever, chills, a history of weight loss, and signs of peripheral emboli. Blood cultures identified Gram-positive Streptococcus parasanguinis, a member of the Streptococcus viridans group. Transesophageal echocardiogram (TEE) identified a large, mobile, pedunculated left atrial mass protruding into the mitral valve in diastole and mitral valve vegetations. Surgical excision and the histology confirmed a diagnosis of benign left atrial myxoma containing Gram-positive cocci. The patient required mitral valve replacement and a postoperative two-week course of gentamicin and a six-week course of ceftriaxone CONCLUSIONS A rare case is reported of infected left atrial myxoma presenting as STEMI secondary to coronary artery embolization, which was treated with PCI, antibiotics, and mitral valve replacement.

Infected cardiac myxoma.

A 66-year-old male presenting with low-grade fever and general fatigue was diagnosed as having infected myxoma of the left atrium. Blood cultures grew Streptococcus mitis. He underwent urgent resection and histological examination revealed tumor cells in a mucopolysaccharide matrix and bacterial colonies along with active inflammation. Infected cardiac myxoma is extremely rare; however, it contains a potential risk of arterial embolization and so early diagnosis and urgent surgery should be considered.

Two sporadic infected cardiac myxomas in 1 patient.

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.

Fever of unknown origin: a case of cardiac myxoma infected with Staphylococcus lugdunensis.

Infected cardiac myxoma is a rare entity. It poses a diagnostic challenge as clinical presentation may reflect an underlying infectious, immune, or a neoplastic disease process. To the best of our knowledge, the first case of a cardiac myxoma infected with Staphylococcus lugdunensis is reported in a 54-year-old man with fever of unknown origin for 4 months. Successful excision of the tumor was performed and was followed by an uneventful recovery. Clinical presentation, diagnosis, and management of infected cardiac myxomas are discussed.

Ruptured abdominal aortic aneurysm after resection of an infected cardiac myxoma.

A 12-year-old girl with a high fever underwent echocardiography and was found to have a myxoma that arose from the atrial side of the anterior mitral valve leaflet. The tumor was successfully excised. Histologic examination of the tumor showed myxoma cells and an organized thrombus with bacterial colonization. The patient was discharged from the hospital on antibiotic treatment. After remaining asymptomatic for 3 weeks, she was readmitted with acute abdomen. Ultrasonography and magnetic resonance angiography detected intra-abdominal hemorrhaging and a saccular aneurysm of the abdominal aorta. The patient underwent successful emergency surgery. To our knowledge, no other report has been published concerning an abdominal aortic aneurysm secondary to bacterial infection of a cardiac myxoma. Although complications this severe are rarely observed in patients who have endocarditis, early recognition and treatment can be life-saving.

Mixoma auricular izquierdo infectado / Infected left atrial myxoma

El mixoma es el tumor primario más frecuente que afecta al corazón. La infección de estos tumores es infrecuente y, en ocasiones, su presentación clínica es indistinguible de un mixoma no infectado. Describimos el caso de una mujer de 58 años con una infección faríngea previa que desarrolló infección sobre un mixoma auricular izquierdo, complicado con embolia sistémica en los miembros inferiores. Se aisló Streptococcus oralis en los hemocultivos y en el material embólico. El tumor se resecó y la evolución clínica posterior resultó sin incidencias. La frecuencia del mixoma infectado es muy baja y una revisión de la bibliografía se ha de basar en los casos aislados publicados

Myxoma is the most common primary tumor of the heart. It is uncommon for these tumors to become infected and, at times, clinical presentation is no different from that of an uninfected myxoma. We describe the case of a 58-year-old woman with a previous pharyngeal infection that developed into infection of a left atrial myxoma and which was complicated by systemic embolism affecting the lower limbs. Streptococcus oralis was identified in blood cultures and embolic material. The tumor was resected and the patient's subsequent clinical evolution was uneventful. The incidence of infected myxoma is very low. A review of the literature based on individual case reports is presented

Angiomixoma superficial / Superficial angiomyxoma

Los angiomixomas superficiales son lesiones cutáneas benignas poco frecuentes y clínicamente muy variables. Normalmente se localizan en tronco, pero también pueden aparecer en miembros inferiores, cabeza y cuello. El diagnóstico es histológico, y se caracteriza por ser un tumor mal delimitado, multinodular y por la presencia de un material mixoide intersticial con escasa celularidad. El tratamiento es quirúrgico, con posibilidad de recurrencia local. Ante la presencia de un angiomixoma superficial habrá que descartar siempre un complejo de Carney asociado. Se presenta el caso de una mujer con un angiomixoma superficial solitario de rápido crecimiento

Superficial angiomyxomas are clinically variable, infrequent, benign skin lesions. They are usually located on the trunk, but can also appear on the lower limbs, head and neck. They are diagnosed histologically, and are characterized by the fact that they are poorly delimited, multinodular tumors, and by the presence of interstitial myxoid material with scanty cellularity. Treatment is through surgery, and local recurrence is possible. An associated Carney's complex must always be ruled out with superficial angiomyxoma. We present the case of a woman with a solitary, fast-growing superficial angiomyxoma

Infected cardiac myxoma.

Infected cardiac myxomas are extremely rare with only forty cases described in the literature. We report a case of an infected cardiac myxoma that presented in a manner similar to bacterial endocarditis. Our case is the first to be diagnosed using previously defined criteria, and is unusual in that transesophageal echocardiography was required to make the diagnosis.

Infected cardiac myxoma.

Infected cardiac myxoma is a rare condition with variable presentation. We report a case of infected cardiac myxoma which presented as fever of unknown origin. Diagnostic considerations and treatment of this condition are discussed.

Infected cardiac myxoma: an unusual phenomenon.

Infected cardiac myxoma is a rare phenomenon. Cardiac myxomas are primary tumors of the heart, usually benign and account for about 50% of the benign cardiac tumors. Patients usually present with a triad of constitutional, embolic, and obstructive symptoms. There are few reported cases of infected cardiac myxoma and there is no widely used definition. This is a case presentation describing a patient who was admitted to our institution, underwent surgical excision, and was subsequently discharged home.

Infected left atrial myxoma with concomitant mitral valve endocarditis.

Myxomas are the most common primary cardiac tumors. They may simulate infective endocarditis but are rarely infected. Currently, 17 infected left atrial myxomas have been reported in the literature [1, 7, 8, 10, 11]. We present a patient with infected left atrial myxoma combined with mitral valve endocarditis, treated by excision of the myxoma and mitral valve reconstruction.

Infected left atrial myxoma caused by Gemella morbillorum.

Gemella morbillorum was isolated from the blood of a 38-year-old woman with a 4-week history of fever. An echocardiogram showed a left atrial tumor. The patient was successfully treated by antibiotic therapy and early surgical excision of the tumor. Histological examination of the excised tumor revealed a typical myxoma with infiltrates of neutrophils and remnants of bacteria. To the best of our knowledge, this is the first reported case of infected left atrial myxoma caused by G. morbillorum.

Infected biatrial myxoma: transesophageal echocardiography-guided surgical resection.

We identified a biatrial myxoma using transesophageal echocardiography whose right atrial component was missed with conventional transthoracic techniques. Identifying the biatrial component directs a safer approach to right heart catheterization. Infected biatrial myxomas are both rare and successfully managed using prolonged intravenous antibiotic therapy followed by resection. Atrial septal defects created during the resection of an infected myxoma may be safely repaired using a prosthetic patch.