International Journal of Clinical & Medical Images

A 14-year-old girl with no comorbids presented with failure symptoms, fever and abdominal pain for 2 weeks. Hemodynamically supported with inotropes and presence of pansystolic murmur heard on auscultation. Abdominal palpation reveals generalized tenderness, more prominent on the left side of the abdomen. Initial working diagnosis of ischaemic bowel was ruled out after CT abdomen performed. Findings show huge splenic infarct and segmental left renal infarct. ECHO was done after admission to the ward. It reveals vegetation at the posterior leaflet of mitral valve with severe mitral regurgitation (Figures 1-4).