Myocardial abscesses unassociated with infective endocarditis

Area of Science:

• Cardiology
• Infectious Diseases
• Pathology

Background:

• Myocardial abscesses are rare cardiac infections.
• Absences of infective endocarditis are often overlooked.
• Diagnosis is frequently missed during a patient's lifetime.

Purpose of the Study:

• To review cases of myocardial abscesses.
• To identify common pathogens and underlying conditions.
• To evaluate diagnostic methods and complications.

Main Methods:

• Retrospective review of 3,084 autopsies from 1967-1977.
• Inclusion of 14 cases of myocardial abscess not associated with infective endocarditis.
• Analysis of clinical data, microbiology, and autopsy findings.

Main Results:

• No cases were diagnosed ante mortem.
• Commonly isolated organisms included Gram-negative bacteria, fungi, and Staphylococcus aureus.
• Associated conditions were alcoholic hepatitis, myocardial infarction, lupus erythematosus, and malignancies.
• Physical exam, chest X-ray, and ECG were not diagnostic.
• Complications included pericarditis and congestive heart failure.

Conclusions:

• A high index of suspicion is crucial for ante mortem diagnosis in non-responsive patients.
• Cardiac scintigraphy shows potential for earlier detection.
• Myocardial abscesses require prompt recognition and treatment.