Infected atrial myxoma

Left atrial myxoma prolapsing into the left ventricle. Case report and review of the literature

Cardiac myxomas are rare tumors which may present differently. Left atrial myxoma is an entity from anatomopathological and clinical aspects. To the best of our knowledge, only 2 cases of infected left atrial myxomas treated surgically have been reported in the last 6 years. Herein, we present a patient with a left atrial myxoma prolapsing into the left ventricle in the diastolic phase, which was infected with Streptococcus viridans. Combined therapy, consisting of surgical management and antimicrobial therapy, was used. Clinical presentation, diagnosis and treatment are reviewed.

Infected cardiac myxoma. Case report and literature review

We present a case of a left atrial myxoma infected with Porphyromonas asaccharolytica in a 55-year-old man, successfully treated with surgical excision and a brief course of antibiotic therapy. Infected cardiac myxomas are extremely rare, with only 39 cases previously reported. They can be difficult to diagnose due to their protean clinical manifestations, which can often be seen in uninfected myxomas as well. We suggest that blood cultures and careful pathologic examination be performed in all cases of cardiac myxoma with constitutional symptoms. However, fever and elevated sedimentation rate are significantly more common in infected tumors. Organisms responsible are similar in distribution to those causing bacterial endocarditis. Emboli, though frequent, may not be more common in infected than uninfected myxomas. Case reports have become more common since the development of better diagnostic techniques. Echocardiography, especially by the transesophageal approach, is the diagnostic procedure of choice, and sensitivity approaches 100%. Surgical excision is curative and generally has low morbidity and mortality.

Infected left atrial myxoma caused by Gemella morbillorum

Gemella morbillorum was isolated from the blood of a 38-year-old woman with a 4-week history of fever. An echocardiogram showed a left atrial tumor. The patient was successfully treated by antibiotic therapy and early surgical excision of the tumor. Histological examination of the excised tumor revealed a typical myxoma with infiltrates of neutrophils and remnants of bacteria. To the best of our knowledge, this is the first reported case of infected left atrial myxoma caused by G. morbillorum.