Infection of left atrial thrombus associated with mitral stenosis: A case report

Left Ventricular Infected Thrombus Detected by 18F-FDG PET/CT and MRI in Disseminated Staphylococcus Infection

We present the case of a 61-year-old woman with fever and acute meningitis. Clinical evaluation revealed maculopapular rash, right gluteus cellulitis, and centered retinal hemorrhages. In the intensive care unit, persistent Staphylococcus bacteremia was detected. However, transesophageal echocardiography did not reveal pathologic features. F-FDG PET/CT and cardiac MRI diagnosed a left ventricular infected thrombus, an extremely rare condition especially in patients without structural cardiopathy.

Left atrial giant thrombus infected by Escherichia Coli. Case report

Background

Left atrial thrombi are mostly related to mitral valve disease. The differential diagnosis of clots and myxomas in the left atrium is mostly based on echocardiography. Infection of intracardiac thrombi is extremely rare and mostly reported in ventricular clots or aneurysms following myocardial infarction.

Case presentation

We present the case of a 65 year old female with a history of mitral valve disease and chronic atrial fibrillation who suffered repeated embolic strokes and a giant infected clot in the left atrium. Although the patient underwent prompt surgery with removal of the clot and valve replacement the complication of septic emboli to the CNS led her to death. To the best of our knowledge this is the second report of an infected left atrial thrombus.

Conclusion

The case is a representative example of a neglected and undertreated patient with catastrophic consequences. Anticoagulant therapy in patients with mitral valve disease and atrial fibrillation should be applied according the currently available guidelines and standards in order to avoid analogous paradigms in the future. Mitral valve substitution should be considered in patients with mitral valve disease presenting thromboembolic complications. Surgery should be considered as the treatment of choice in cases of organized left atrial thrombus and suspected tumor or infected mass.

Syncope with a twist

Left atrial ball thrombus is an uncommon entity, seen more commonly in the presence of mitral valve disease. We present here a case of a large left atrial thrombus presenting as sudden cardiac death.