Spontaneous Bacterial Coronary Sinus Septic Thrombophlebitis Treated Successfully Medically

Abstract

A 38-year-old farmer was hospitalized for fever, chills, cough, and chest pain lasting for 7 days. Due to persistent symptoms, patient was referred to hospital. Blood cultures identified oxacillin-sensitive Staphylococcus aureus (OSSA). Transthoracic echocardiography (TTE) showed large pericardial effusion, a mobile heterogeneous mass originating from the coronary sinus ostium, no sign of valvular endocarditis. Pericardiocentesis was done carrying out purulent fluid, microbiological culture isolating an OSSA. Parenteral penicillin M was administered for 6 weeks. At the end of this antibiotherapy regimen, TTE showed no coronary sinus mass with complete vacuity of the coronary sinus vein and no pericardial effusion.

Coronary sinus endocarditis in a hemodialysis patient: A case report and review of literature

“…However, both need to be distinguished because they require different treatments. CS vegetation, including infective endocarditis or septic thrombophlebitis, has been reported in 13 cases, including our case (Table 1 )[ 4 , 7 - 17 ]. According to these cases, patients with CS vegetation mainly had symptoms and signs of infection, such as fever and leukocytosis, and had typical imaging or pathologic findings involving the CS.…”

Right‐sided endocarditis: eustachian valve and coronary sinus involvement

“…Complications can include septic emboli to the pulmonary vasculature and abdominal viscera. The majority of the six previously reported cases also described oxacillin‐sensitive Staphylococcus which resolved with antibiotics . Two cases required surgical excision after failure of antibiotic therapy for 7–10 days, along with an increase in vegetation size …”