Nonbacterial thrombotic endocarditis as the sole manifestation of stage IV gastric cancer: a case report

Journal of Medical Case Reports

Arafat Tfayli⁴  Ehab Saad Aldin³  Alain Rizkallah¹  Wassim Shatila² 

[1] Department of Internal Medicine, American University of Beirut Medical Center, PO Box 11-0236, Riad El-Solh 1107-2020 Beirut, Lebanon;Department of Internal Medicine, Duke University, 1020 Goldmist Lane, Durham, North Carolina 27713, USA;Medstar Good Samaritan Hospital, 5601 Loch Raven Boulevard, Baltimore, Maryland 21239, USA;Division of Hematology/Oncology, American University of Beirut Medical Center, PO Box 11-0236, Riad El-Solh 1107-2020 Beirut, Lebanon

关键词: Thrombosis;    Stomach neoplasms;    Noninfective;    Nonbacterial;    Endocarditis;    Embolism;   

Others  :  1181085
DOI  :  10.1186/1752-1947-8-267

 received in 2014-01-06, accepted in 2014-06-26,  发布年份 2014

【 摘 要 】

Introduction

Nonbacterial thrombotic endocarditis is a very rare complication of malignancy and other hypercoagulable states. It describes the deposition of small sterile smooth or verrucoid vegetations on the valve leaflets, causing a clinical picture similar to that of bacterial endocarditis. The authors reported this case because this is a rare and unusual first manifestation of malignancy generally and of gastric cancer particularly, with only a few reports present in the literature.

Case presentation

The authors present a case of a 36-year-old Caucasian male with occult gastric cancer whose first and only manifestation was nonbacterial thrombotic endocarditis causing extensive multi-organ infarctions.

Conclusions

An endocarditis not responsive to antibiotics should raise the suspicion of an occult malignancy. Differentiating between an infective endocarditis and a nonbacterial thrombotic endocarditis will cause a radical change in the management which will eventually affect the patient’s prognosis.

【 授权许可】

   
2014 Shatila et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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