Left Ventricular Pseudoaneurysm Caused by Infective Endocarditis.
A 32-year-old male presented with infective endocarditis and left ventricular pseudoaneurysm (PA). The patient was treated with oxacillin but remained intermittently febrile for the next 3 weeks. Blood culture revealed Staphylococcus aureus. Treatment with oxacillin 2 g every 4 hours gradually reduced the fever. Echocardiography then showed an aneurysm-like structure communicating with the left ventricle. However, the patient refused further examinations and insisted on discharge. After 4 days, he was readmitted to our ward with severe dyspnea. Chest computed tomography showed the heart was behind a huge PA. The selected treatments for this rare case of multiple medical conditions were surgical resection of the PA and mitral valve replacement surgery, which achieved a gradual recovery. In this case, early diagnosis and timely surgical intervention resulted in an excellent prognosis.


BACKGROUND
Infective endocarditis; Pseudoaneurysm; Staphylococcus aureus.
Department of Internal Medicine, Division of Cardiology, Kaohsiung Veterans General Hospital; ; Department of Biological Sciences, National Sun Yat-sen University; ; Institute of Clinical Medicine, National Yang-Ming University;
Tung-Chen
TC
Yeh
Department of Internal Medicine, Division of Cardiology, Kaohsiung Veterans General Hospital;
Chun-Peng
CP
Liu
Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung; ; Institute of Clinical Medicine, National Yang-Ming University; ; Department of Pharmacology, National Defense Medical Center, Taipei; ; Institute of Biomedical Science, National Sun Yat-sen University, Kaohsiung, Taiwan.
Ching-Jiunn
CJ
Tseng
Department of Surgery, Division of Cardiovascular Surgery;
Pa-Rum
PR
Can
Department of Biological Sciences, National Sun Yat-sen University;
Jau-Cheng
JC
Liou