Cardiac myxoma presenting with fever of unknown origin

The clinical manifestations of cardiac myxoma can be miscellaneous and uncharacteristic, which may lead to delayed diagnosis and treatment, and ultimately an unexpected poor prognosis. Of these, fever of unknown origin is one of the rare manifestations of cardiac myxoma. A 56-year-old female presenting with sustained low-grade fever showed poor response to antibiotic treatment. Later, she developed chest discomfort and exertional dyspnea. She was inspected with echocardiography, which revealed a left atrial myxoma. She underwent cardiac myxoma resection. After the operation, she was complicated with complete heart block. She recovered to normal sinus rhythm on postoperative day 12 by temporary pacemaker and low-dose intravenous isoprenaline, followed by oral medications. Patients with fever of unknown origin with poor response to antibiotic treatments should raise the suspicions of cardiac myxoma and an echocardiographic examination is necessary.