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[A candida bezoar in the Chiari reticulum of the right heart atrium]
Insights
A rare autopsy finding revealed a 3 cm fungus ball, composed of Candida mycelia, in the heart’s right atrium. This unusual cardiac mycetoma likely resulted from prior Candida septicemia and indwelling catheter use.
Area of Science:
- Pathology
- Mycology
- Cardiology
Background:
- Incidental autopsy finding in a 55-year-old woman with uterine cervical carcinoma.
- A 3 cm polyp attached to the Chiari's rete in the right atrium was initially suspected as metastasis or tumor.
Purpose of the Study:
- To identify the nature of an unusual cardiac mass found during autopsy.
- To discuss the potential causes of cardiac mycetoma in the context of patient history and literature.
Main Methods:
- Gross examination of the cardiac lesion.
- Histologic examination to determine the composition of the mass.
- Review of patient history, including prior Candida septicemia and treatment.
Main Results:
- Histology confirmed the lesion was a fungus ball composed of Candida mycelia.
- The patient had a history of Candida septicemia treated with antibiotics via an indwelling catheter.
Conclusions:
- The cardiac fungus ball represents an unusual manifestation of Candida infection.
- Indwelling catheters and prior septicemia are potential risk factors for disseminated fungal infections, including cardiac mycetoma.
Abstract:
An incidental finding at autopsy in a 55-year-old woman who died of complications of uterine cervical carcinoma was a 3 cm long polyp attached to the rete of Chiari in the right atrium. The lesion was interpreted grossly as either a pedunculated metastasis to the heart or an unusual atrial tumor. Histologic examination revealed it to be a fungus ball composed of regularly grouped Candida mycelia. The patient's history revealed Candida septicemia several months prior to death for which she had been treated by heavy doses of antibiotics administered through indwelling catheter. The causes of this unusual anatomo-pathologic finding are discussed in the light of our observations and those reviewed in the literature.