Abstract
We successfully treated a case of active infective endocarditis in the remission phase of virus-associated hemophagocytic syndrome (VAHS). A 21-year-old man was admitted to our hospital for fever, arthralgia, and general fatigue. His blood cultures revealed staphylococcus epidermidis. He underwent urgent aortic valve replacement and closure of the abscess cavity because of an ineffective antibiotic therapy and a progressive left heart failure. Operative findings showed about 100 ml bloody pericardial effusion, fresh vegetation on the aortic left coronary and non-coronary leaflets, and aortic root abscess just below the left coronary ostium. The aortic root abscess extended to the left ventricular wall between the base of left atrial appendage and the base of main pulmonary artery and was in the state of impending rupture. The left main coronary artery was fully exposed after debridement in the abscess cavity. It was thought that left atrial appendage as a pedicle was useful for filling up the abscess cavity to protect infection.
Similar content being viewed by others
References
Risdall RJ, Mckenna RW, Nesbit ME, Krivit W, Balfour HH Jr, Simmons RL: Virus-associated hemophagocytic syndrome. A benign histiocytic proliferation distinct from malignant histiocytosis. Cancer 44: 993–1002, 1979
Tsuda H, Maeda Y, Nakagawa K, Nakayama M, Nishimura H, Ishihara A, Miyayama H: Parbovirus B19-associated haemophagocytic syndrome with prominent neutrophilia. Br J Haematology 86: 413–414, 1994
Watanabe G, Haverich A, Speier R, Dresler C, Borst HG: Surgical treatment of active infective endocarditis. J Thorac Cardiovasc Surgery 107: 171–177, 1994
Danielson GK, Titus Jb, DuShane JW: Successful treatment of aortic valve endocarditis and aortic root abscesses by insertion of prosthetic valve in ascending aorta and placement of bypass grafts to coronary arteries. J Thorac Cardiovasc Surgery 67: 443–449, 1974
Frantz PT, Murray GF, Wilcox BR: Surgical management of left ventricular-aortic discontinuity complicating bacterial endocarditis. Ann Thoracic Surg 29: 1–7, 1980
Reitz BA, Stinson EB, Watson DC, Baumgartner WA, Jamieson SW: Translocation of the aortic valve for prosthetic valve endocarditis. J Thorac Cardiovasc Surgery 81: 212–218, 1981
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Arioka, I., Maeta, H., Takazawa, A. et al. A case of active infective endocarditis in the remission phase of virus-associated hemophagocytic syndrome. Jpn J Thorac Caridovasc Surg 46, 570–574 (1998). https://doi.org/10.1007/BF03250602
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03250602