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Histological detection of intramyocardial abscesses in Candida sepsis mimicking left ventricular

C Stöllberger1, J Preiser, J Finsterer

  • 12nd Medical Department, Krankenanstalt Rudolfstiftung, Wien, Austria. claudia.stoellberger@chello.at

Mycoses
|March 5, 2004
PubMed

Insights

Cardiac microabscesses from Candida sepsis can mimic left ventricular non-compaction/hypertrabeculation (LVHT). This rare finding, not visible on echocardiography, highlights the importance of considering fungal infections in LVHT differential diagnoses.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pathology

Background:

  • Left ventricular non-compaction/hypertrabeculation (LVHT) is a rare congenital heart defect.
  • LVHT is characterized by prominent ventricular trabeculations and is often associated with neuromuscular disorders.
  • Differential diagnoses for LVHT include thrombi, hypertrophic cardiomyopathy, and cardiac tumors.

Observation:

  • A case of a 55-year-old man with hypopharyngeal carcinoma treated with chemotherapy is presented.
  • The patient developed cardiac microabscesses due to Candida sepsis.
  • These microabscesses mimicked LVHT on initial assessment but were only confirmed histologically.

Findings:

  • Intramyocardial abscesses, particularly those caused by Candida sepsis, have not been previously reported as a differential diagnosis for LVHT.
  • Echocardiography failed to detect the microabscesses, emphasizing the limitations of imaging in certain conditions.
  • Histologic examination was crucial for diagnosing the fungal microabscesses.

Implications:

  • This case expands the differential diagnosis of LVHT to include intramyocardial abscesses.
  • It underscores the need for considering invasive fungal infections in patients with unexplained cardiac findings, especially those who are immunocompromised.
  • Further research may be warranted to elucidate the frequency and diagnostic challenges of fungal endocarditis presenting as LVHT mimics.

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