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European Heart Journal Advance Access originally published online on August 17, 2006
European Heart Journal 2007 28(1):58; doi:10.1093/eurheartj/ehl168
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Echocardiographic detection of intracardiac non-metallic foreign body complicated by infective endocarditis

Li Yang*, Jingfeng Wang and Wei Wu

Department of Cardiology, Second Affiliated Hospital, Sun Yet-Sen University, Guangzhou 510120, China

* Corresponding author. Tel: +86 20 81332070; fax: +86 20 81332853. E-mail address: lyc.yang{at}tom.com

An 11-year-old boy was referred for unexplained fever of 3 months. Laboratory tests showed elevated white blood cell count with a left shift, and decreased haemoglobin level. Blood cultures at admission were negative. Chest radiograph displayed no abnormal findings. The illness responded poorly to antibiotics. Echocardiography revealed moderate-sized, highly mobile, non-homogeneous masses in both atria, with ‘stalk’ attached to each side of the interatrial septum (Panel A). The mass in the left atrium protrudes into the left ventricular inflow tract during diastole (Panel B). The ‘stalk’ of the masses appeared like a ‘fragment of a catheter’ penetrating the septum (Panel C). At open-heart surgery, the masses were successfully excised, together with a small portion of the muscular part of the septum around the point of attachment (Panel D). Surprisingly, a 6 cm-long and 0.1 cm-diameter bamboo stick (Panel D) was discovered in the left atrium with one of its tips pointing towards the septum where the masses attached. The bamboo stick was removed followed by septum repair.

On further investigation, it was learnt that the boy had a history of falling over himself and chest injury 1 year before, but without known injury of his heart. Cultures from the removed masses grew Serratia marcescens. Histopathological examination confirmed the masses to be vegetations. Cefminox and Etimicin were prescribed for antibiotic therapy. The boy recovered rapidly and was discharged uneventfully. On follow-up visits, he showed complete recovery from the disease without recurrence of fever 6 months after the operation.

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This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
28/1/58    most recent
ehl168v1
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