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European Journal of Echocardiography 2008 9(2):336-337; doi:10.1093/ejechocard/jen009
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Aquarium sign in sepsis

Rui André Providência*, Paula Mota, Nuno Quintal, Isabel Quintal and António Manuel Leitao-Marques

Serviço de Cardiologia, Centro Hospitalar de Coimbra, Hospital Geral, Quinta dos Vales, 3041-801 S. Martinho do Bispo, Coimbre, Portugal

Received 24 September 2007; received in revised form 30 October 2007; accepted after revision 7 November 2007.

* Corresponding author. Tel: +35 1961023760; fax: +35 1239814779. E-mail address: rui_providencia{at}yahoo.com


  Abstract

A 91-year-old man appeared in our lab with fever for a transthoracic echocardiography assessment. Highly unusual echo images were found, with a size and movement resembling ‘bubbles in an aquarium’ in every cardiac chamber, both left and right. The patient died 8 days later, due to a methicillin-resistant Staphylococcus aureus sepsis. These are highly unusual images that should not be confused with microbubbles from contrast agents or radiofrequency ablation, and were previously reported once in association with atrioesophageal fistula.

Keywords: Microbubbles; Aquarium sign; Sepsis


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