Mitral valve vegetation diagnosed with oesophageal ultrasound with bronchoscope (EUS-B)

Ajoe John Kattoor, Yogita M. Rochlani, Kevin Kuriakose, Nikhil K. Meena

Research output: Contribution to journalArticlepeer-review

Abstract

Oesophageal ultrasound with bronchoscope (EUS-B) is designed to evaluate mediastinal structures. We describe a case of a 78-year-old woman who presented with altered mental status for 2 weeks. CT head revealed a subacute infarct in the right middle cerebral artery distribution. She was also found to have a lung mass on chest imaging. EUS-B-guided fine needle aspiration demonstrated the presence of adenocarcinoma in station 7 lymph node and in the mass. Immunohistochemistry confirmed it to be a lung primary as the Thyroid Transcription Factor-1 (TTF-1) was strongly positive. During the procedure, the cardiac valves were evaluated, and a mitral valve vegetation was noted. Formal echocardiography confirmed the presence of the vegetation. During hospital stay, the patient developed fever. Her blood cultures grew oxacillin-resistant Staphylococcus aureus. She was subsequently treated for infective endocarditis. We suggest that the use of EUS-B to routinely scan adjacent structures during a procedure may help obtain additional clinical information that may be critical to patient management.

Original languageEnglish (US)
Article number218849
JournalBMJ case reports
Volume2017
DOIs
StatePublished - 2017
Externally publishedYes

Keywords

  • Adult intensive care
  • Cancer intervention
  • Geriatric medicine
  • Valvar diseases

ASJC Scopus subject areas

  • Medicine(all)

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