Papillary fibroelastoma complicated by Streptococcus sanguinis bacteremia: a rare case of cardiac tumor with embolic events

Sirine Ahmad, Mohammed Alsaeed

Abstract


Fibroelastoma is a rare cardiac tumor that can cause embolization, stroke, myocardial infarction, heart failure, and cardiac arrest.Here, we report the case of a 45-year-old male who presented with right-sided weakness and fever. He was diagnosed with acute right frontal infarction and was found to have Streptococcus sanguinis bacteremia. Upon confirmation of a positive blood culture after 24 hours, treatment for endocarditis was initiated. Transesophageal echocardiography revealed findings highly suggestive of a papillary fibroelastoma (PFE). PFE ought to be regarded as a potential differential diagnosis in individuals who exhibit symptoms of fever, thromboembolism, and persistent bacteremia. Non-invasive imaging such as echocardiography is of great value in the diagnosis of PFE, while surgical resection remains the best treatment modality to overcome current and future associated complications.

Keywords


papillary fibroelastoma; Streptococcus sanguinis; thromboembolic events

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References


Devanabanda AR, Lee LS. Papillary Fibroelastoma. 2023 Apr 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31751019.

Zoltowska DM, Sadic E, Becoats K, et al. Cardiac papillary fibroelastoma. J Geriatr Cardiol. 2021 May 28;18(5):346-351. doi: 10.11909/j.issn.1671-5411.2021.05.009. PMID: 34149823; PMCID: PMC8185441.

Sun JP, Asher CR, Yang XS, et al. Clinical and echocardiographic characteristics of papillary fibroelastomas: a retrospective and prospective study in 162 patients. Circulation. 2001 Jun 5;103(22):2687-93. doi: 10.1161/01.cir.103.22.2687. PMID: 11390338.

Ahmed R, Moaddab A, Graham-Hill S. A Case of Papillary Fibroelastoma of the Aortic Valve Causing an Embolic Ischemic Stroke. Cureus. 2022 Aug 20;14(8):e28208. doi: 10.7759/cureus.28208. PMID: 36158373; PMCID: PMC9484706.

Klarich KW, Enriquez-Sarano M, Gura GM, et al. Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation. J Am Coll Cardiol. 1997 Sep;30(3):784-90. doi: 10.1016/s0735-1097(97)00211-8. PMID: 9283541.

Almagro UA, Perry LS, Choi H, Pintar K. Papillary fibroelastoma of the heart. Report of six cases. Arch Pathol Lab Med. 1982 Jul;106(7):318-21. PMID: 6896442.

Roberts WC. Papillary fibroelastomas of the heart. Am J Cardiol. 1997 Oct 1;80(7):973-5. doi: 10.1016/s0002-9149(97)00586-9. PMID: 9382025.

Miller A, Perez A, Pabba S, Shetty V. Aortic valve papillary fibroelastoma causing embolic strokes: a case report and review. Int Med Case Rep J. 2017 Mar 29;10:109-112. doi: 10.2147/IMCRJ.S119353. PMID: 28435328; PMCID: PMC5386611.

Kalman JM, Lubicz S, Brennan JB, Vernon-Roberts E, Calafiore P. Multiple cardiac papillary fibroelastomas and rheumatic heart disease. Aust N Z J Med. 1991 Oct;21(5):744-6. doi: 10.1111/j.1445-5994.1991.tb01382.x. PMID: 1759925.

Koji T, Fujioka M, Imai H, et al. Infected papillary fibroelastoma attached to the atrial septum. Circ J. 2002 Mar;66(3):305-7. doi: 10.1253/circj.66.305. PMID: 11922284.

Latif F, Peyton M, Laszik Z, Sivaram CA. Infective endocarditis of a papillary fibroelastoma on Chiari network of right atrium: a case report. J Am Soc Echocardiogr. 2008 Feb;21(2):188.e3-4. doi: 10.1016/j.echo.2007.08.033. PMID: 17928193.




DOI: http://dx.doi.org/10.22551/2024.42.1101.10279

Copyright (c) 2024 Sirine Ahmad, Mohammed Alsaeed

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