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Isolated Apical Intracavitary Left Ventricular Abscess in a Normal Heart: A Rare Complication of Streptococcus Milleri Endocarditis

Abscess formation is a common complication of infective ~ndocarditis 1. It can occur locally, at the site of the original infection, or peripherally as the result of embolization of septic debris from the heart. When an abscess develops within the heart itself, in the course of an infective endocarditis, it can originate in the fibrinous masses which contain the causative organism, the so-called infective vegetations. These are most often located on native (particularly if diseased) or prosthetic valves. They also occur at sites of flow disturbance (such as the perivalvular regions, ventricular septal defects, etc.) and on sites of damaged endocardium (old infarctions, rheumatic endocarditis, etc). We report a case of Streptococcus milleri endocarditis complicated by intracardiac abscess formation in an atypical location (the apex of the left ventricle) in which none of the valves was affected.