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A 55-year-old man presented with fever of 3 weeks duration. Clinical examination revealed pallor, clubbing, cardiomegaly, an early diastolic murmur and mild hepatosplenomegaly. Laboratory investigations revealed raised C-reactive protein, leucocytosis and microscopic haematuria. Blood culture yielded no growth. Echocardiography showed a multiloculated abscess in the interventricular septum, resembling a honeycomb, extending from the aortic root and projecting into left ventricular outflow tract (figure 1; see online supplementary videos 1 and 2). There was severe aortic regurgitation. Patient was treated as culture negative endocarditis. Successful aortic valve replacement was done after 3 weeks of antibiotic therapy. Operative findings were confirmative.
Supplementary materials
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Files in this Data Supplement:
- Data supplement 1 - Online video I
- Data supplement 2 - Online video II
Footnotes
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Contributors GR: substantial contributions to conception and design, acquisition of data or analysis and interpretation of data. BK: drafting the article or revising it critically for important intellectual content. VH: final approval of the version to be published.
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Competing interests None.
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Patient consent Obtained.
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Provenance and peer review Not commissioned; internally peer reviewed.