title: Afebrile Pannus-Induced Blood Culture-Negative Mechanical Valve Endocarditis.
abstract: The diagnosis of prosthetic valve endocarditis may be challenging in patients with an atypical clinical presentation. Virtually all infections associated with mechanical prosthetic valves are localized to the prosthesis-tissue junction at the sewing ring and are accompanied by tissue destruction around the prosthesis. Because the orifice of the mechanical prosthetic valve is made of metal and pyrolytic carbon, which do not enable the adherence of microorganisms, any vegetation originating from the interior of the valve orifice is usually rare. Here we present a rare case of pannus-induced mechanical prosthetic valve endocarditis that was difficult to diagnose.
authors.affiliation: Nagasaki University School of Medicine, Department of Cardiovascular Surgery, Department of Cardiovascular Medicine, Nagasaki, Japan. Electronic address: smatsu731@nagasaki-u.ac.jp.
authors.forename: Seiji
authors.initials: S
authors.lastname: Matsukuma
authors.affiliation: Nagasaki University School of Medicine, Department of Cardiovascular Surgery, Department of Cardiovascular Medicine, Nagasaki, Japan.
authors.forename: Kiyoyuki
authors.initials: K
authors.lastname: Eishi
authors.affiliation: Nagasaki University School of Medicine, Department of Cardiovascular Surgery, Department of Cardiovascular Medicine, Nagasaki, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Tanigawa
authors.affiliation: Nagasaki University School of Medicine, Department of Cardiovascular Surgery, Department of Cardiovascular Medicine, Nagasaki, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Miura
authors.affiliation: Nagasaki University School of Medicine, Department of Cardiovascular Surgery, Department of Cardiovascular Medicine, Nagasaki, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Matsumaru
authors.affiliation: Nagasaki University School of Medicine, Department of Cardiovascular Surgery, Department of Cardiovascular Medicine, Nagasaki, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Hisatomi
authors.affiliation: Nagasaki University School of Medicine, Department of Cardiovascular Surgery, Department of Cardiovascular Medicine, Nagasaki, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuneto
mesh_terms: D000368:Aged; D000071997:Blood Culture; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy