Lung abscess seen on echocardiography

Lung abscess seen on echocardiography Image Focus 1 IMAGE FOCUS doi:10.1093/ehjci/jey073 .................................................................................................................................................... 1 2 Michael J. Crawford * and John C. Moscona 1 2 Department of Internal Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, SL50, New Orleans, 70112 LA, USA; and Heart & Vascular Institute, Tulane University School of Medicine, 1415 Tulane Avenue, New Orleans, 70112 LA, USA * Corresponding author. Tel: 405-760-6700; Fax: 504-988-5263. E-mail: mcrawfo5@tulane.edu A 68-year-old woman presented with worsening shortness of breath on exer- tion. She had a past medical history signifi- cant for heart failure with preserved ejection fraction and pulmonary Mycobacterium abscessus infection. Chest radiograph showed bilateral pleural effu- sions with bibasilar airspace disease. Transthoracic echocardiography (TTE) showed a normal ejection fraction but also revealed a hyperechoic mass in the pleural space lateral to the left ventricle (Panels A and B). Given these findings, computed tomography (CT) scan of the chest was ordered and showed a left lower lobe consolidation with interval areas of low attenuation concerning for abscess formation (Panels C and D). In addition to treatment for heart failure exacerbation, she received antibiotic therapy for suspected pulmonary M. abscessus infection. Invasive interventions were avoided given her several comorbidities. Mycobacterium abscessus is a rapidly growing mycobacterium that is known to cause pulmonary infections. In patients with suspected infection, radiographic evi- dence is important in making a diagnosis. Evaluation generally involves chest radio- graph and CT scan, but other imaging modalities, including TTE, may aid in detection. Supplementary data are available at European Heart Journal – Cardiovascular Imaging online. V C Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2018. For permissions, please email: journals.permissions@oup.com. Downloaded from https://academic.oup.com/ehjcimaging/advance-article-abstract/doi/10.1093/ehjci/jey073/5017263 by Ed 'DeepDyve' Gillespie user on 11 July 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Heart Journal – Cardiovascular Imaging Oxford University Press

Lung abscess seen on echocardiography

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Oxford University Press
Copyright
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.
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2047-2404
D.O.I.
10.1093/ehjci/jey073
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Abstract

Image Focus 1 IMAGE FOCUS doi:10.1093/ehjci/jey073 .................................................................................................................................................... 1 2 Michael J. Crawford * and John C. Moscona 1 2 Department of Internal Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, SL50, New Orleans, 70112 LA, USA; and Heart & Vascular Institute, Tulane University School of Medicine, 1415 Tulane Avenue, New Orleans, 70112 LA, USA * Corresponding author. Tel: 405-760-6700; Fax: 504-988-5263. E-mail: mcrawfo5@tulane.edu A 68-year-old woman presented with worsening shortness of breath on exer- tion. She had a past medical history signifi- cant for heart failure with preserved ejection fraction and pulmonary Mycobacterium abscessus infection. Chest radiograph showed bilateral pleural effu- sions with bibasilar airspace disease. Transthoracic echocardiography (TTE) showed a normal ejection fraction but also revealed a hyperechoic mass in the pleural space lateral to the left ventricle (Panels A and B). Given these findings, computed tomography (CT) scan of the chest was ordered and showed a left lower lobe consolidation with interval areas of low attenuation concerning for abscess formation (Panels C and D). In addition to treatment for heart failure exacerbation, she received antibiotic therapy for suspected pulmonary M. abscessus infection. Invasive interventions were avoided given her several comorbidities. Mycobacterium abscessus is a rapidly growing mycobacterium that is known to cause pulmonary infections. In patients with suspected infection, radiographic evi- dence is important in making a diagnosis. Evaluation generally involves chest radio- graph and CT scan, but other imaging modalities, including TTE, may aid in detection. Supplementary data are available at European Heart Journal – Cardiovascular Imaging online. V C Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2018. For permissions, please email: journals.permissions@oup.com. Downloaded from https://academic.oup.com/ehjcimaging/advance-article-abstract/doi/10.1093/ehjci/jey073/5017263 by Ed 'DeepDyve' Gillespie user on 11 July 2018

Journal

European Heart Journal – Cardiovascular ImagingOxford University Press

Published: May 26, 2018

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