PMC8220318_01
A case of native valve endocarditis and pacemaker infection with Mycobacterium fortuitum.. (A) Two-dimensional transthoracic echocardiography showing 1.2 cm mobile mass attached to the pacemaker lead at the base of the posterior leaflet of the tricuspid valve. (B) Gram stain from OR cultures showing beady gram-positive bacilli (right panel); acid-fast stain showing positive Mycobacterium (bright pink, left panel). (C) Two-dimensional transesophageal echocardiography showing 0.872 mm vegetation on the tricuspid valve.
gr1.jpg
PMC8220318_01_gr1.jpg
fig0005
Transthoracic echocardiography (TTE) showed 1.2 cm mobile mass attached to the ICD lead at the base of the posterior leaflet of the tricuspid valve suggestive of vegetation (Fig. 1A). The acid-fast stain was positive (Fig. 1B, left panel), while the gram stain from the intraoperative culture showed beaded gram-positive bacilli (Fig. 1B, right panel). TEE showed hypoechoic mobile vegetation on the tricuspid valve measuring 0.87 cm without evidence of tricuspid regurgitation (Fig. 1C).