CTICasesInfective Endocarditis with Massive Mitral Vegetation
Imaging findings
CT angiography and cardiac MRI in a patient with Streptococcus mitis bacteremia demonstrate a massive, shaggy, and mobile vegetation (measuring 18x8 mm) attached to the mitral valve apparatus, associated with severe mitral regurgitation and left ventricular dilation.
Key takeaways
Streptococcus mitis endocarditis can present with exceptionally large, mobile vegetations on the mitral valve, often following dental procedures. Cardiac MRI is helpful to distinguish the vegetation from a primary cardiac myxoma, though surgical resection is urgently required due to the high risk of embolic stroke.
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