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Fungal myocarditis
1Department of Medicine, Division of Infectious Diseases, Albert Einstein College of Medicine, Bronx, NY 10461, USA. nosanchu@aecom.yu.edu
Abstract:
The incidence of invasive fungal disease has dramatically increased over the past few decades corresponding to the rising number of immunocompromised patients. The major risk factors for severe fungal disease include administration of broad-spectrum antibiotics, corticosteroids and cytotoxic agents, invasive medical procedures, and Human Immunodeficiency Virus (HIV) infection. Invasive fungal infections often affect multiple organs, and involvement of the myocardium frequently occurs in disseminated disease. Premortem diagnosis of fungal myocarditis is difficult since clinical findings of myocardial involvement are often absent or ambiguous and blood cultures are often negative. The major fungal pathogens responsible for myocardial infection and the clinical settings in which they occur are reviewed.
Insights
Invasive fungal infections are rising in immunocompromised individuals, often affecting the heart. Diagnosing fungal myocarditis before death is challenging due to subtle symptoms and negative blood cultures.
Area of Science:
- Mycology
- Infectious Diseases
- Cardiology
Background:
- Rising incidence of invasive fungal disease linked to increased immunocompromised populations.
- Key risk factors include immunosuppressive therapies, invasive procedures, and HIV infection.
- Disseminated fungal infections frequently involve multiple organs, including the myocardium.
Purpose of the Study:
- To review major fungal pathogens causing myocardial infection.
- To describe the clinical settings associated with fungal myocarditis.
- To highlight diagnostic challenges in premortem identification of fungal myocarditis.
Main Methods:
- Literature review of fungal myocarditis cases and pathogens.
- Analysis of clinical presentations and risk factors.
- Discussion of diagnostic difficulties and current approaches.
Main Results:
- Fungal myocarditis is a complication of disseminated fungal infections.
- Diagnosis is often delayed or missed due to nonspecific clinical signs.
- Blood cultures are frequently negative, complicating early detection.
Conclusions:
- Fungal myocarditis poses a significant diagnostic challenge.
- Awareness of risk factors and potential fungal pathogens is crucial.
- Further research into improved diagnostic methods is warranted.