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Asymmetric Septal Hypertrophy in the Differential Diagnosis of Endocarditis

Asymmetric Septal Hypertrophy in the Differential Diagnosis of Endocarditis Abstract To the Editor. —The sudden onset of a heart murmur in a patient with fever, bacteremia, and a central venous catheter should raise the possibility of infective endocarditis until proved otherwise. The following case report describes a patient with these clinical features who did not have endocarditis. Report of a Case. —A 61-year-old woman, previously in good health, had acute myelomonocytic leukemia. On Feb 8, 1982, a right subclavian intravenous (IV) line was inserted for the administration of chemotherapy. Five days later, fever and chills developed, together with pain at the catheter site. On physical examination, the patient's temperature was 38.7 °C, her BP was 160/90 mm Hg, and her pulse rate was 100 beats per minute. There was a purulent discharge at the catheter site with evidence of cellulitis around it. Results of the rest of the examination were unremarkable. Laboratory data showed a hemoglobin level of 9 g/dL, References 1. Klemme JW, Breen JF: Increased risk of bacterial endocarditis with idiopathic hypertrophic subaortic stenosis. J Fla Med Assoc 1981;68:369-370. 2. Henry WL, Clark CE, Epstein SE: Asymmetric septal hypertrophy (ASH): The unifying link in the IHSS disease spectrum. Circulation 1973;47:827-832.Crossref 3. Rajpal RS, Leibsohn JA, Liekweg WG, et al: Infected left atrial myxoma with bacteremia simulating infective endocarditis. Arch Intern Med 1979;139:1176-1178.Crossref 4. Martin RP, Meltzer RS, Chia BL, et al: Clinical utility of two dimensional echocardiography in infective endocarditis. Am J Cardiol 1980;46:379-385.Crossref 5. Sotman SB, Schimpff SC, Young VM: Staphylococcus aureus bacteremia in patients with acute leukemia. Am J Med 1980;69:814-818.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Asymmetric Septal Hypertrophy in the Differential Diagnosis of Endocarditis

Archives of Internal Medicine , Volume 143 (10) – Oct 1, 1983

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350100208054
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —The sudden onset of a heart murmur in a patient with fever, bacteremia, and a central venous catheter should raise the possibility of infective endocarditis until proved otherwise. The following case report describes a patient with these clinical features who did not have endocarditis. Report of a Case. —A 61-year-old woman, previously in good health, had acute myelomonocytic leukemia. On Feb 8, 1982, a right subclavian intravenous (IV) line was inserted for the administration of chemotherapy. Five days later, fever and chills developed, together with pain at the catheter site. On physical examination, the patient's temperature was 38.7 °C, her BP was 160/90 mm Hg, and her pulse rate was 100 beats per minute. There was a purulent discharge at the catheter site with evidence of cellulitis around it. Results of the rest of the examination were unremarkable. Laboratory data showed a hemoglobin level of 9 g/dL, References 1. Klemme JW, Breen JF: Increased risk of bacterial endocarditis with idiopathic hypertrophic subaortic stenosis. J Fla Med Assoc 1981;68:369-370. 2. Henry WL, Clark CE, Epstein SE: Asymmetric septal hypertrophy (ASH): The unifying link in the IHSS disease spectrum. Circulation 1973;47:827-832.Crossref 3. Rajpal RS, Leibsohn JA, Liekweg WG, et al: Infected left atrial myxoma with bacteremia simulating infective endocarditis. Arch Intern Med 1979;139:1176-1178.Crossref 4. Martin RP, Meltzer RS, Chia BL, et al: Clinical utility of two dimensional echocardiography in infective endocarditis. Am J Cardiol 1980;46:379-385.Crossref 5. Sotman SB, Schimpff SC, Young VM: Staphylococcus aureus bacteremia in patients with acute leukemia. Am J Med 1980;69:814-818.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1983

References