Nonbacterial Thrombotic (Marantic) Endocarditis

摘要

A 19-year-old man with aplastic anemia underwent a matched unrelated bone marrow transplant. He later developed severecomplications including graft versus host disease, cytomegalovirus, aspergillus, herpes zoster and H1N1 influenza infections anddialysis dependant renal failure. His mental status fluctuated during his hospital stay and he required intensive support formulti-organ system dysfunction. Shortly after a CT scan, he was noted to have an episode of sudden chest pain following whichhe became unresponsive with unreactive pupils. Resuscitative measures were started, but after no response, efforts were terminatedand the patient was pronounced dead.Autopsy demonstrated cardiomegaly with biventricular hypertrophy and severe narrowing of the coronary arteries. Scatteredareas of myocardial necrosis with surrounding foci of myocytolysis were present in the left ventricle. There was also evidenceof nonbacterial thrombotic (marantic) endocarditis of the mitral valve.