Case 223. MRSA endocarditis (55 y-o M)
         
    Autopsied heart with large verruca formation and ulceration in the aortic valve in case of disseminated malignancy    
         
   
Key words : Staphylococcus aureus, MRSA, endocarditis, septicemia
   
     
 
     
Infective endocarditis involving the aortic valve. Red-colored verruca is attached and the cusp is ulcerated (gross findings).   Heavily basophilic cocci are densely colonized in the destroyed valvular tissue (HE, low power).
     
 
     
Colonies of heavily basophilic cocci are seen in the fibrinous matrix (HE, high power). MRSA was cultured from the blood.   Septic microabscess formed in the myocardium is demonstrated. Neutrophils are clustered around the Gram-positive coccal colony (Gram).