Left atrial giant thrombus infected by Escherichia Coli. Case report

We present the case of a 65 year old female with a history of mitral valve disease and chronic atrial fibrillation who suffered repeated embolic strokes and a giant infected clot in the left atrium. Although the patient underwent prompt surgery with removal of the clot and valve replacement the complication of septic emboli to the CNS led her to death. To the best of our knowledge this is the second report of an infected left atrial thrombus.The case is a representative example of a neglected and undertreated patient with catastrophic consequences. Anticoagulant therapy in patients with mitral valve disease and atrial fibrillation should be applied according the currently available guidelines and standards in order to avoid analogous paradigms in the future. Mitral valve substitution should be considered in patients with mitral valve disease presenting thromboembolic complications. Surgery should be considered as the treatment of choice in cases of organized left atrial thrombus and suspected tumor or infected mass.Cardiac mural thrombosis is a complication of mitral valve disease frequently related to systemic thromboembolism. Infected intracardiac thrombi are extremely rare and mostly reported in ventricular chamber. So far there has been only one case of an infected thrombus in the left atrium [1]. This report describes the case of a patient with a history of mitral valve disease and atrial fibrillation with repeated embolic strokes in the past presenting a giant infected clot in the left atrium. Although the patient underwent surgery and removal of the clot the frequency and the severity of the strokes along with the complications of septic emboli to the CNS led her to death.A 65 year old woman was admitted to our hospital with disturbances of consciousness ensued during the last two days. She had been suffering from mitral stenosis for 15 years and was under medical supervision, receiving digoxin, furosemide and warfarin. She had suffered three embolic strokes