PMC9879835_01
Computerized tomography scan showing an abnormal hypodense area in the centre of the cardiac silhouette.
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Emergency cardiac catheterization (see Supplementary material online, Figure S1) revealed non-obstructive coronary artery disease and normal ejection fraction with elevated end-diastolic pressure of 32 mmHg.
Transoesophageal echocardiogram showing an abnormal cavity at basal and mid inter ventricular septum.
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CT chest) (Figure 2; see Supplementary material online, Videos S1 andS2). CT abdomen and pelvis with contrast was negative for any focus of infection.
Pathological specimen of the heart showing infectious cavity at the level of interventricular septum.
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The cardiac autopsy revealed an abscess containing cavity in the interventricular septum, communicating both with the right and left ventricles (Figure 3).
The pericardium pathological examination showed an extensive deposition of the fibrin admixed with neutrophils consistent with fibrinous pericarditis (A). The pathology of the myocardium showed significant neutrophils in the interstitium, abscess formation, and active myocyte damage consistent with acute myocarditis (B).
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The pericardium had extensive deposition of the fibrin admixed with neutrophils consistent with fibrinous pericarditis (Figure 4).