PMC10209695_01
Echocardiogram with view of mitral valve and vegetation.
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Transesophageal echocardiogram demonstrated an independently mobile "shaggy looking" echo-density measuring 1.5 cm by 0.82 cm attached to the distal portion of the A3 scallop of the mitral valve which was associated with severe mitral regurgitation (Fig. 1).
(a): Granulation tissue with diffuse neutrophilic infiltrates. H&E, 10x. (b) Area of marked myxoid degeneration. H&E, 10x (c) Myxoid area at the right adjacent to area of mixed inflammation, fibrin, and bacterial colonization at the low left. H&E, 10x. (d) same area of 10x magnification. H&E.
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Microbiologic analysis of the excised valve also demonstrated Lactobacillus jensenii (Fig. 2a-d).