[Echocardiographic detection of tricuspid valve endocarditis and right atrial and ventricular masses in a patient with acute myeloid leukaemia].
In a patient with acute leukaemia, tricuspid valve vegetations and both right atrial and ventricular masses formed within a few weeks were detected by echocardiography. In addition to endocarditis which is a very rare condition in patients with acute leukaemia, the diagnostic efforts including cardiac surgery resulted in the unusual finding of right-sided cardiac thrombi which had formed autochthonously. The most likely cause was thought to be a very severe systemic infection with staphylococci characterised by repeated episodes of bacteraemia during profound and prolonged neutropenia as well as a paraneoplastic coagulopathy. Surgery performed on the grounds of the echocardiography findings and differential-diagnostic considerations resulted in the relapse-free removal of the infectious focus. The maintenance therapy for leukaemia could thus be continued and led to a distinctly improved outcome. This case report confirms the great importance of sonography in the management of fever of unknown origin in immunocompromised patients.
Buchheidt
D
D
Medizinische Klinik, Universitätsklinikum Mannheim, Ruprecht-Karls-Universität Heidelberg, Germany.
Weiss
A
A
Jakob
H
H
Hehlmann
R
R
D000208:Acute Disease; D018572:Disease-Free Survival; D004452:Echocardiography; D004696:Endocarditis / Q000000981:diagnostic imaging* / Q000209:etiology; D006325:Heart Atria; D006338:Heart Neoplasms / Q000000981:diagnostic imaging*; D006352:Heart Ventricles; D006801:Humans; D007951:Leukemia, Myeloid / Q000150:complications*; D008297:Male; D008875:Middle Aged; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery