Myocardial mucormycosis with emboli in a hemodialysis patient

A 32-year-old man was found to have disseminated mucormycosis. Echocardiogram demonstrated bilateral ventricular thrombi, but there were no segmental wall motion abnormalities. At autopsy, it was found that these thrombi originated from a myocardial abscess and that death had been caused by septic embolization to the brain. The patient had been on maintenance hemodialysis for 9 years. Two transplants, 7 and 8 years previously, had been unsuccessful and had involved only 3 weeks of immunosuppressive treatment. No factor predisposing to fungal infection could be identified, with the possible exception of chronic uremia.