Letter to Editor: Complete cure with medical treatment of prosthetic mitral valve endocarditis, which is initially diagnosed as mitral valve thrombus

Dear Editor, A 59-year-old male patient was admitted to hospital with a complaint of fatigue and anorexia. He underwent mitral valve replacement operation nine months before the presentation. After the operation, patient attended control examinations irregularly. On admission; his blood pressure, heart rate and body temperature were within the normal range. Physical examination was also normal except prosthetic valve sound on auscultation. Electrocardiogram showed normal sinus rhythm and first laboratory findings were as following: INR: 1.64, prothrombin time: 21.8 second, sedimentation rate: 83 mm/h, hemoglobin: 13.9 gr/dl, hematocrit: 41.8%, platelets: 278000/mm3, white blood cells: 11200/ mm3 with 82% of granulocytes. Transthoracic echocardiography revealed thrombus at the edge of prosthetic valve. Transesophageal echocardiography (TEE) displayed multiple and mobile with a maximum of 1.4x0.4 cm sized thrombus at sutured site of prosthetic valve (Fig. 1).