An Unusual Cause of Endocarditis

(clinical microbiology and infection vol:6 - 2000, no:6: )

A 44-year-old female patient was admitted to the Cardiology Institute. Istanbul University with cardiac arrythmia and fatigue. She had been treated for mitral valve prolapse since age 28. Transthoracic echocardiography (TTE) revealed prominent prolapse of the mitral and tricuspid valves, mitral insufficieney and dilatation of the left ventricular cavity. Left ventricular ejection fraction was calculated as 70%. The patient had a history of raw milk ingestion over the last few years. One month after her initial admission. She had a body temperature of 39 C. arthralgia and swollen knees. Despite antibiotic therapy. Her fever persisted for 2-3 months. With a weight loss of about 10 kg. On transesophageal echocardiography (TEE). A 1-cm floppy mass was found on the anterior leaflet of the mitral valve. Which was interpreted as a vegetation.