[Infective endocarditis of the interatrial septum due to a mitral regurgitant jet].

A 54-year-old man with a medical history of diabetes, dyslipidemia, and abdominal aneurysm was seen for fever of 1 month’s evolution with no attributable focus. The physical examination was notable for high-pitched IV/VI systolic murmur at the mitral valve; the remaining examination was unremarkable. Laboratory findings included anemia (hemoglobin, 10.6), erythrocyte sedimentation rate, 80; and mildly elevated carcinoembryonic antigen (7.5). Hepatic lesions seen on ultrasound study and a positive blood culture for Streptococcus viridans suggested a diagnosis of fever with a tumor origin rather than endocarditis. Transthoracic echocardiography showed posterior mitral valve prolapse with severe regurgitation and no signs of vegetations. Transesophageal echocardiography revealed eversion of the posterior valve due to rupture of cords, with severe eccentric regurgitation toward the interatrial septum, where a 1-cm nodular image was visualized. Because of the atypical appearance of the mass, antibiotic therapy was IMAGE IN CARDIOLOGY