Abstract
We report here a case of active infective endocarditis caused by Methicilin-ResistantStaphylococcus aureus (MRSA). A 24-year-old woman was admitted to the Osaka Medical Collage Hospital with continuous fever. After admission, MRSA was detected by blood culture and chemotherapy with Vancomycin was started. However, after 1 week, her condition had not improved. Moreover, a pedicled vegetation on the posterior wall of the left atrium and mitral regurgitation due to prolapse of the anterior leaflet were revealed by transesophageal echocar-diography. The vegetation grew to about 2 cm in diameter and prolapsed into the left ventricle during diastole. We performed an early operation although the infection was still active due to its rapid growth and the risk of embolism. There was a large pedicled vegetation on the posterior wall of the left atrium as shown by preoperative echocardiography, but the mitral valve appeared to be intact. Therefore, the vegetation was completely removed and the mitral annulus was plicated by Kay’s method to treat the associated mitral regurgitation. Postoperatively, we administered VCM 2 g/day for 24 days. The course was uneventful. The patient was discharged from the hospital on the 31th postoperative day.
Similar content being viewed by others
References
47: 209–213, 1994
39: 602–603, 1991
Alsip SG, Blackstone EH, Kirklin JW, Cobbs CG: Indications for cardiac surgery in patients with active infective endocarditis. Am J Med 79: 138–148, 1985
D’Agostino RS, Miller DC, Stinson EB, Mitchell RS, Oyer PE, Jamieson SW, Baldwin JC, Shumway NE: Valve replacement in patients with native valve endocarditis. What really determines operative outcome ? Ann Thorac Surg 40: 429–438, 1985
49: 669–671, 1996
49: 621–624, 1996
Lopez JA, Ross RS, Fishbein MC, Siegel RJ: Nonbacterial thrombotic endocarditis. A review. Am Heart J. 113: 773–784, 1987
49: 641–645, 1996
Savage DD, Garrison RJ, Devereux RB, Castelli WP, Anderson SJ, Levy D, McNamara PM, Stokes J III, Kannel WB, Manning Feinleib: Mitral valve prolapse in the general population. I. Epidemiologic features. The Framingham Study. Am Heart J 106: 571–576, 1983
50: 857–859, 1997
MRSA 49: 680–683, 1996
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yuda, A., Asada, K., Hasegawa, S. et al. A case report of infective endocarditis caused by MRSA and characterized by pedicled vegetation on the posterior wall of left atrium. Jpn J Thorac Caridovasc Surg 46, 915–918 (1998). https://doi.org/10.1007/BF03217845
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03217845