title: Silent large vegetative mitral-aortic enterococcal endocarditis.
abstract: : In spite of the evolution of diagnostic and imaging tools, infective endocarditis still remains a challenging diagnostic problem. We report the case of a 77-year-old heart failure patient with a very large mitral vegetative lesion but without fever or any other clinical or microbiological 'endocarditis criteria' except the echocardiographic findings. In this scenario, the second more likely differential diagnosis was neoformation of the mitral valve but despite an exhaustive preoperative diagnostic cardiac imaging, this hypothesis could not be excluded before surgical excision and microbiological examination of the surgical specimen.
authors.affiliation: aDivision of Cardiology, Rovigo General Hospital, Rovigo bDivision of Cardiology cDivision of Cardiovascular Surgery, Verona University Hospital, Verona dCardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Conte
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.forename: Claudio
authors.initials: C
authors.lastname: Picariello
authors.forename: Marco
authors.initials: M
authors.lastname: Zuin
authors.forename: Riccardo G
authors.initials: RG
authors.lastname: Abbasciano
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rigatelli
authors.forename: Loris
authors.initials: L
authors.lastname: Roncon
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D058070:Asymptomatic Diseases; D001431:Bacteriological Techniques; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D013293:Enterococcus faecalis / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D000072078:Positron Emission Tomography Computed Tomography; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents