[Loeffler's endocarditis and disseminated viral infection]

We report a case of Löffler's endocarditis in a 60-year-old woman with multiple lymphadenopathies, blood eosinophilia and acute heart failure. The eosinophilia developed over a six-month period to a maximum of 54.5% eosinophiles for 7600 X 10(9) leukocytes/l. Five weeks before death lymph node biopsy revealed Hodgkin's disease with mixed cellularity. Autopsy disclosed parietal endocarditis with endomyocardial fibrosis and mural thrombi, principally in the inflow tract of the left ventricle, lesions typical of the fibroplastic parietal endocarditis described by Löffler. Examination of the lymph nodes at autopsy showed a disseminated viral infection probably due to a virus of the herpes group, as was confirmed by electron microscopy. Since these findings disagree with the interpretation of the lymph node biopsy we think the diagnosis of Hodgkin's disease should be withdrawn. Löffler's endocarditis is discussed with reference to pathological features, differential diagnosis and lymph node changes in the patient.