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Three years after radio-frequency ablation of the atrioventricular nodes, followed by the implantation of a dual-chamber pacemaker, a 59-year-old man had gradual onset of fever and left-sided chest discomfort. He had no history of immunocompromise or pulmonary disease. Three sets of blood cultures were sterile. The chest radiograph showed minimal enlargement of the cardiac shadow and clear lung fields. Transesophageal echocardiography showed a mass attached to the tricuspid valve, with mild tricuspid regurgitation (Panel A; LA denotes left atrium, LV left ventricle, RV right ventricle, and RA right atrium). The pacemaker was replaced with a temporary electrode. Culture of the . . . [Full Text of this Article] |
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