LAUSR

A 35-YEAR-OLD man (weight 67 kg, height 169.9 cm), with a history of cough, dyspnea on exertion, and hemoptysis of 90 days’ duration, presented to the authors’ institution for further evaluation. Eight months before his presentation, he underwent radiofrequency catheter ablation for paroxysmal atrial fibrillation. About 5 months after the procedure, he was admitted to the hospital in respiratory distress with dyspnea and hemoptysis. Thoracic computed tomography showed left upper lobe consolidation (Fig 1). He was treated initially for pneumonia, but his symptoms persisted. Sputum culture for tuberculosis and bronchial lavage for acid-fast bacilli excluded tuberculosis. Transthoracic and transesophageal echocardiography was performed as part of the diagnostic evaluation, and the following images were obtained (Figs 2 and 3; Video Clip 1). What is the diagnosis?