Huge tricuspid valve abscess.
A 60-year-old woman with colorectal adenocarcinoma underwent surgical mass resection in 2003; hepatic segmentectomy due to hepatic metastasis was performed in 2005. A port-a-cath for the administration of chemotherapy was cannulated. In April 2007, the patient developed fever and shivering, and the catheter was removed. Catheter and blood cultures were positive for methicillin-sensitive Staphylococcus aureus. TEE showed a very mobile mass (3 x 2 cm) at the junction of the posterior and anterior leaflets of the tricuspid valve. The mass had large echolucent areas inside, exhibiting an appearance like a 'ball of wool' (Panel B). Cardiac MRI confirmed the presence of a mass attached to the tricuspid valve, as shown in the delayed enhancement sequence. At surgery, a ruptured tendinous cord as well as a large abscess within the septal leaflet of the tricuspid valve was found.
Manzano Nieto
Carmen M
CM
Instituto Cardiovascular, Hospital Universitario San Carlos, Madrid, Spain.
Vilacosta
Isidre
I
Corros
Cecilia
C
Almería
Carlos
C
Rodríguez
Enrique
E
D000038:Abscess / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery