title: Unusual presentation and echocardiographic management of giant mural endocarditis occurring simultaneously with aneurysmatic aorta.
abstract: We describe a 32-year-old man who presented in a febrile, unconscious state with unusual staphylococcal endocarditis. We diagnosed the patient's illness by using transthoracic echocardiography (TTE), which revealed a giant vegetation on the left ventricular lateral wall. The patient had history of aortic valve replacement and coarctoplasty. Conservative treatment using repeated TTEs resulted in successful management of endocarditis and embolic brain abscess. After discharge, the patient underwent aortic reconstruction for the aneurysmatic dilatation of ascending aorta. This report confirms that chronic endocardial trauma may provide a fertile nidus for the development of bacterial vegetation. The clinical, echocardiographic, and laboratory findings contributed to therapeutic decision-making in the management of this case.
authors.affiliation: Department of Cardiology, Division of Echocardiography, Medical Sciences/University of Tehran, Tehran, Iran. azoroufian@gmail.com
authors.forename: Arezoo
authors.initials: A
authors.lastname: Zoroufian
authors.forename: Mohammad
authors.initials: M
authors.lastname: Sahebjam
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Nematipour
authors.forename: Elham Hakki
authors.initials: EH
authors.lastname: Kazzazi
authors.forename: Ali
authors.initials: A
authors.lastname: Abbasi
mesh_terms: D000328:Adult; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D004452:Echocardiography / Q000379:methods*; D004696:Endocarditis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome