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Necrotizing infection of the heart

Published:February 05, 2018DOI:https://doi.org/10.1016/j.clinimag.2018.01.014

      Highlights

      • CT demonstrated pneumomyocardium at the inferior wall of the heart.
      • Appearance at surgery, surgical pathology, and positive culture suggested necrotizing infection.
      • Pneumomyocardium is a rare CT finding; pneumopericardium is more common.

      Abstract

      A case of necrotizing infection of the heart is presented. A 70-year-old woman presented with vague chest and abdominal pain. CT of the abdomen and pelvis was initially obtained, which demonstrated gas in the myocardium of the left ventricle. Subsequent chest CT, endoscopy, and abdominal surgical exploration did not reveal perforated viscus or diaphragm compromise. At median sternotomy, the inferior wall of the heart was found to be necrotic. Culture of the excised tissue grew E. coli. The patient expired shortly after surgical exploration.

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