Endokarditis

A radiologic

review of hoarse voice from anatomic and neurologic perspectives. Endocarditis. A 41-year-old previously healthy man presents with intermittent hoarse voice and unexpected weight loss. Axial contrast-enhanced CT images through the larynx (a) and mediastinum (b) reveal left vocal fold rotation (white arrow) and lymphadenopathy surrounding the left carotid and subclavian arteries (white arrowheads). A coronal CTA image (c) reveals an ascending aortic aneurysm (black arrows). Echocardiogram (d) reveals a bicuspid valve with vegetations (gray arrow) and severe aortic stenosis. Overall, findings are consistent with compression/stretching of the left recurrent laryngeal nerve due to reactive lymphadenopathy and a dilated aortic arch in the setting of endocarditis