title: Fever of unknown origin from a left atrial myxoma: an immunologic basis and cytokine association.
abstract: Myxoma is the most common primary tumor of the heart. The typical presentations include a triad of embolic phenomena, intracardiac flow obstruction, and constitutional symptoms. We report a case of cardiac myxoma presenting as prolonged fever. Leukocytosis with a left shift, anemia, and elevated C-reactive protein were noted. A large left atrial myxoma was found incidentally by chest computed tomography. The fever subsided after surgical removal of the myxoma. His elevated serum interleukin-4 (IL-4), IL-6, IL-12 p70, interferon-γ, and tumor necrosis factor-α returned to undetectable levels four days after surgery. Cardiac myxomas should be included in the differential diagnosis of prolonged fever, even though no typical symptoms could be found.
authors: Department of Critical Care Medicine, Division of Infectious Diseases, and Division of Cardiovascular Surgery, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
authors: Jiun-Nong
authors: JN
authors: Lin
authors: Chung-Hsu
authors: CH
authors: Lai
authors: Li-Fen
authors: LF
authors: Lu
authors: Hsi-Hsun
authors: HH
authors: Lin