Successful Treatment of Left Atrial Auricular Abscess

Mural endocarditis causing myocardial abscess without valvular involvement is very rare. We report an unusual case of left atrial auricular abscess which was successfully treated by surgical resection, treatment with antibiotics, and mediastinal irrigation. A 9-yr-old female patient with previous history of urinary tract infection was admitted because of persistent fever. Echocardiography and magnetic resonance imaging revealed massive pericardial effusion and a mass lesion at the left upper cardiac border. Pericardiocentesis isolated Staphylococcus aureus on culture. The patient underwent mass removal under cardiopulmonary bypass. The mass was located in the left atrial auricle with fibropurulent abscess formation inside. Postoperative mediastinal irrigation was performed using povidone iodine solution. Pathological examination of the mass showed organized thrombi with chronic fibrosing mural endocarditis.

Aspergillus Infection in a Large Thrombus of a Permanent Ventricular Pacing Lead

Pacemaker lead infection is a rare but a dangerous complication. Diagnosis can usually be established by the clinical picture and blood cultures. Transesophageal two dimensional echocardiography might be crucial in the diagnosis by visualizing pacing lead vegetations. Medical treatment alone is rarely successful, and several studies have suggested the infected pacemaker systems should be removed quickly for optimal management. We describe a case of Aspergillus infection in a permanent ventricular pacing lead, which appears to be the first reported case in Korea. A 30-yr-old man was evaluated for the symptoms and signs of congestive heart failure 3 yr after DDD pacemaker implantation. The transthoracic and transesophageal echocardiogram showed a large movable round shaggy mass attached to a ventricular lead in the right atrium. The atrial and ventricular leads were removed during cardiopulmonary bypass, and a new epicardial pacing system was implanted. The functional ventricular pacemaker lead was encased in a large organized thrombus. Histological findings were consistent with Aspergillus infection in a large thrombus attached to a pacemaker lead.

Endocardite por fungos no período neonatal. Relato de um caso com grande massa intra-atrial direita / Fungal endocarditis in the neonatal period. Report of a case with large right atrial mass

Objetivo: Chamar a atençäo dos pediatras para o diagnóstico de Endocardite por Fungo no período neonatal, que pode surgir como complicaçäo do uso de cateter venoso central. Método: Os autores descrevem um caso de Endocardite por Fungo no período neonal, confirmado por exame histopatológico, e fazem revisäo de literatura sobre o tema no MEDLINE e LILACS desde 1980. Resultado: Recém-nascido internado para tratamento de Kernicterus, sem cardiopatia prévia, que necessitou do uso de cateter venoso central. Na evoluçäo surgiu quadro de febre intermitente e sopro cardíaco. Na cultura da ponta do cateter cresceu Cândida sp. Submetido a exame ecocardiográfico, foi detectada grande massa intra-atrial direita, a qual foi retirada cirurgicamente...