A case presentation of intracardiac thrombus formation and development of massive pulmonary embolism following brucella infection

Abstract

Brucella infection can lead to vascular complications such as intracardiac thrombus. In this case, we presented a case of acute pulmonary embolism due to right atrial thrombus secondary to brucella infection. A 74-year-old male patient presented with complaints of shortness of breath and palpitations. He exhibited hypotension and tachycardia in vital signs, along with hypoxia and hypocarbia in laboratory parameters. The patient had a diagnosis of brucella and under active medical treatment. Transthoracic echocardiography revealed a worm-like hyperechoic intracavitary mass in the right atrium which has rough contours and synchronously move with adjacent heart wall during heart cyles. The right atrium and right ventricle were dilated. Computed tomography showed a hypodense lesion consistent with embolism in the left main pulmonary artery. Due to hemodynamic instability and the development of shock, the patient received thrombolytic therapy. Following stabilization of vital signs, the patient was discharged smoothly on vitamin K antagonist (VKA) therapy.