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A 59-year-old man was admitted for intermittent fever. His temperature was 38 degrees C, white blood cell counts 19,800/mm3, C-reactive protein 17.9 mg/dL. Interleukin 6 (IL-6) serum level was 31.0 pg/mL. Transesophageal echocardiography showed a 6 x 4 cm left atrial tumor arising from the atrial septum. We strongly suspected that left atrial myxoma caused the fever. The tumor was excised with the aid of cardiopulmonary bypass. Tumor histology was typical of a cardiac myxoma. The serum IL-6 level decreased rapidly in postoperative two weeks (5.3 pg/mL). In this patient, IL-6 plasma level might be used as a marker of recurrence.

HighlightsCase of infective endocarditis caused by a rare pathogen, Aggregatibacter aphrophilus is presented.Aggregatibacter aphrophilus can’t be detected by common culture methods.Br-PCR testing is a useful tool to identify pathogens of culture negative endocarditis.Serum PR3-ANCA can be positive in Aggregatibacter aphrophilus endocarditis.