title: Infected papillary fibroelastoma attached to the atrial septum.
abstract: A 61-year-old woman had intermittent fever of 2 months' duration following a dental extraction. On admission, her body temperature was 39.2 degrees C. A mid-systolic murmur was heard at the apex on ausculation. A 2-dimensional echocardiogram revealed a mobile, heavy stick-like mass with vegetation (5.0 x 1.5 cm) attached to the left atrial septum. Multiple blood cultures grew Streptococcus constellatus. On diagnosis of an infected left atrial myxoma, antibiotics were administered daily and 4 weeks later, the left atrial tumor was resected. The tumor was 5.3cm long, 1.5cm in diameter at the inter-atrial wall and had vegetation on the free edge. On microscopic examination, colonies of Gram-positive cocci were found in the thrombus, on the papillary fibroelastoma. After treatment with antibiotics for a further 4 weeks, the patient was discharged. This is the first report of infected papillary fibroelastoma.
authors.affiliation: Department of Internal Medicine, Yamamoto General Hospital, Kuwana, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Koji
authors.forename: Masaki
authors.initials: M
authors.lastname: Fujioka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imai
authors.forename: Takuya
authors.initials: T
authors.lastname: Komada
authors.forename: Masaki
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Takehiko
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Tameda
authors.forename: Fusako
authors.initials: F
authors.lastname: Sato
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakano
mesh_terms: D005260:Female; D005350:Fibroma / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D006325:Heart Atria / Q000382:microbiology / Q000473:pathology; D006338:Heart Neoplasms / Q000382:microbiology* / Q000473:pathology* / Q000628:therapy; D006346:Heart Septum / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D013290:Streptococcal Infections; D034365:Streptococcus constellatus