PMC6131402_01
T2 (left) and diffuse-weighted (right) magnetic resonance imaging scans of the brain showing subacute infarcts of the right MCA and left frontal territories.
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A Neurology consult was obtained and recommended a brain MRI which revealed subacute infarcts of the right MCA and left frontal territories with intermixed foci of subacute hemorrhage and mild mass effect with some of the lesions (Fig. 1).
TEE 2-D image showing a large vegetation on the aortic valve.
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aortic surface of the non-coronary cusp (Fig. 2), and an 8 x 6mm slightly mobile mass attached at the medial commissure of the mitral annulus on the left atrial side (Fig. 3), both consistent with vegetation.
TEE 2-D image showing a large mobile vegetation in the tricuspid valve.
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A large 34mm multi-lobulated mass associated with the anterior tricuspid valve leaflet consistent with vegetation was also seen (Fig. 4), along with mild to moderate tricuspid valve regurgitation.
CT scans of the chest revealing multiple bilateral cavitary lesions in the lungs compatible with septic emboli. Bilateral pleural effusions are also noted.
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A CT scan of the chest and abdomen was obtained to look for other sources of infection or possible abscesses and revealed multiple bilateral cavitary nodules in the lungs compatible with septic emboli, along with bilateral pleural effusions with adjacent consolidations for which bilateral chest tubes were placed (Fig. 5).
Embolus to the tip of the 5th toe on the right foot, associated with sloughing and a small amount of yellow discharge. (The color version of the figure is available in the electronic copy of the article).
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Embolic phenomena to the fingers and toes were also noted (Fig. 6).