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Medical Science Monitor Basic Research


Vegetation Attached to the Left Interatrial Septal Surface at the Congenital Location of the Foramen Ovale: A Rare Occurrence

Unusual clinical course, Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Waqas Javed Siddiqui, Ishan Acharya, Praneet Iyer, Muhammad Yasir Khan, Muhammad Rafique, Anand Kaji, Ketan Gala

USA Department of Nephrology, Drexel University College of Medicine, Philadelphia, PA, PA, USA

Am J Case Rep 2016; 17:837-840

DOI: 10.12659/AJCR.900848

Available online: 2016-11-09

Published: 2016-11-09


BACKGROUND: Non-valvular mural infective endocarditis (IE) is a rare bacterial growth on cardiac walls. Several risk factors have been reported. Echocardiography is an important diagnostic modality for diagnosing vegetation attached to the intracardiac walls.
CASE REPORT: We present the case of a 57-year-old man admitted with Staphylococcus aureus bacteremia due to an infected tunnelled hemodialyses catheter. Transthoracic echocardiogram did not show any abnormality, but transesophageal echocardiogram (TEE) revealed a 1.7×0.8 cm mobile echo-density attached to the surface of the interatrial septum in the left atrium, where the foramen ovale (FO) exists in utero. The patient was transferred to another facility for re-do sternotomy cardiac surgery, where these findings were confirmed intraoperatively. A biopsy of the mass was taken, which confirmed it to be a vegetation attached to the FO.
CONCLUSIONS: We report the first case in the literature of vegetation attached to the surface of the interatrial septum in the left atrium at the congenital location of the foramen ovale. There have been no previously reported cases in the literature with such novel imaging findings.

Keywords: Echocardiography, Transesophageal, Endocarditis, foramen ovale, Foramen Ovale, Patent