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(Circulation. 1996;94:2040.)
© 1996 American Heart Association, Inc.

Articles

Fungal Mass on the Tricuspid Valve

James Mathew, MD; Robert Gasior, MD; Natarajan Thannoli, MD

Correspondence to James Mathew, MD, Chairman, Division of Adult Cardiology, Cook County Hospital, 1835 W Harrison St, Chicago, IL 60612.

	Introduction

 
A 33-year-old man with a history of intravenous drug use was admitted to the hospital with fever, cough, and shortness of breath lasting for about 4 weeks. Physical examination was remarkable for evidence of tricuspid valve (TV) regurgitation. A transthoracic echocardiogram revealed a mass on the TV and an enlarged right atrium. Blood cultures grew Candida albicans. The cauliflower-like mass was better visualized on the transesophageal echocardiogram (Fig 1). The patient was treated with amphotericin B and TV resection. At surgery, the mass attached to the TV filled about 80% of the enlarged right atrium and measured 6.5x4.5 cm (Fig 2). The patient died of multisystem failure from sepsis 8 weeks after surgery.

View larger version (127K): [in this window] [in a new window]   Figure 1. Transesophageal echocardiographic image in a patient with infective endocarditis due to Candida albicans.

View larger version (101K): [in this window] [in a new window]   Figure 2. Intraoperative photograph of fungal mass on the tricuspid valve in a patient with infective endocarditis due to Candida albicans.

	Footnotes

 
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner, MC 4-265, Houston, TX 77030.

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