RESUMO
Resumen: Se presenta el caso de un hombre de 61 años, portador de un cáncer pulmonar en quien lesiones de aspecto embólico llevan al diagnóstico de Endocarditis marántica (no infecciosa). Se describen las características clínicas del paciente, los métodos diagnósticos incluyendo imágenes ecocardiográficas y la confirmación necrópsica.
Abstracts: A 61-year-old male with skin lesions suggesting embolic phenomena, was thoroughly investigated and a final diagnosis of marantic (non-infectious) endocarditis was established. Clinical characteristics and diagnostic investigation through laboratory test and images sustained the diagnosis. The use of transesophageal echocardiography is emphasized. This was finally confirmed by findings at necropsy.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Adenocarcinoma Papilar/complicações , Endocardite não Infecciosa/etiologia , Endocardite não Infecciosa/diagnóstico por imagem , Neoplasias Pulmonares/complicações , Imageamento por Ressonância Magnética , Adenocarcinoma Papilar/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Evolução Fatal , Ecocardiografia Transesofagiana , Embolia/etiologia , Neoplasias Pulmonares/diagnóstico por imagemRESUMO
Marantic or nonbacterial thrombotic endocarditis is characterized for the presence of vegetations formed by a meshwork of fibrin and other cellular material similar a blood clot, without the presence of microorganisms. It is often related with tumors and chronic inflammatory states. We report a 49 years old female with a history of weight loss and asthenia, presenting with multiple cerebrovascular attacks and fever. Blood cultures were negative and the fever did not subside with antibiotic treatment. Trans esophageal echocardiogram showed a mitral valve vegetation and thickening of the free edge of both leaflets. In search of the etiology of such a case, a primary pancreatic cancer with distant metastases was found. We cannot rule out the differential diagnosis with bacterial endocarditis with negative blood cultures, although the clinical context supports a non-infectious etiology.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Endocardite não Infecciosa/patologia , Endocardite não Infecciosa/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Imageamento por Ressonância Magnética , Radiografia Torácica , Tomografia Computadorizada por Raios X , Evolução Fatal , Acidente Vascular Cerebral/diagnóstico por imagem , Diagnóstico DiferencialRESUMO
Marantic or nonbacterial thrombotic endocarditis is characterized for the presence of vegetations formed by a meshwork of fibrin and other cellular material similar a blood clot, without the presence of microorganisms. It is often related with tumors and chronic inflammatory states. We report a 49 years old female with a history of weight loss and asthenia, presenting with multiple cerebrovascular attacks and fever. Blood cultures were negative and the fever did not subside with antibiotic treatment. Trans esophageal echocardiogram showed a mitral valve vegetation and thickening of the free edge of both leaflets. In search of the etiology of such a case, a primary pancreatic cancer with distant metastases was found. We cannot rule out the differential diagnosis with bacterial endocarditis with negative blood cultures, although the clinical context supports a non-infectious etiology.