Systemic septic embolisation secondary to an atrial myxoma in a young woman.
We present a case of a left atrial myxoma infected with Staphylococcus aureus in a 35-year-old woman who was found to have a retained tampon. Multiple systemic septic emboli were seen on computed tomography imaging of the brain, spleen and kidneys. She was successfully treated by surgical excision of the myxoma and 4 weeks of antibiotic therapy. We postulate that the source of this patient's S. aureus infection was tampon use, leading to a toxic shock syndrome and causing infection of an undiagnosed left atrial myxoma, which led to the embolisation. As far as the authors are aware, this is the first reported case of such an entity. In those with an underlying cardiac predisposition, tampon use may represent a risk of infection with S. aureus, and we intend to heighten clinical awareness of this potentially life-threatening association. We also discuss the diagnosis, complications and treatment of infected atrial myxoma and illustrate the imaging findings.
Veitch
Alice M
AM
Department of Clinical Radiology, Derriford Hospital, Plymouth, PL6 8DH, UK. amveitch@doctors.org.uk
Manghat
Nathan E
NE
Kakani
Nirmal K
NK
Lewis
C Terence
CT
Ring
Nicholas J
NJ
D000328:Adult; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006338:Heart Neoplasms / Q000150:complications* / Q000601:surgery; D006801:Humans; D009232:Myxoma / Q000150:complications* / Q000601:surgery; D012772:Shock, Septic / Q000150:complications* / Q000188:drug therapy; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy; D013630:Tampons, Surgical; D014057:Tomography, X-Ray Computed