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[Mycoses of the heart]
M Resl1, M Otcenásek, I Steiner
1Fingerlandův ústav patologie LF UK, Hradec Králové.
Abstract:
There is an increasing frequency of heart mycoses. Authors identified 19 such cases between 1972 and 1991, 63% in the last 6 years (frequency was 0.1% in 17.661 autopsies of patients over 7 days of life). Males prevailed (17:2). Yeasts of genus Candida dominated, unusual etiology represented Candida parapsilosis, Torulopsis candida and Aspergillus restrictus. Sampling from vegetations or abscesses was a prerequisite for positive autoptic cultivation. Probable source of infection was found in 12 patients and 5 of them had an infected thrombosis of venous catheter. Mycosepsis comprised nearly equal number of endocarditides (mostly left sided) and myocarditides. Spread of endocardial infection into myocardium was rare, most myocarditides resulted from disseminated infection in immunocompromised patients. Endocarditides mainly complicated surgical interventions.
Insights
Heart mycoses, fungal infections of the heart, are increasingly frequent, particularly among males. Candida yeasts are the most common cause, often linked to venous catheter infections and surgical complications.
Area of Science:
- Cardiology
- Mycology
- Infectious Diseases
Context:
- Increasing incidence of heart mycoses observed between 1972 and 1991.
- Fungal infections accounted for 0.1% of 17,661 autopsies in patients over seven days old.
- Males were disproportionately affected (17:2 ratio).
Purpose:
- To analyze the frequency, causes, and clinical presentation of heart mycoses.
- To identify the etiological agents and sources of fungal cardiac infections.
- To differentiate between endocarditis and myocarditis in fungal infections.
Summary:
- The study identified 19 cases of heart mycoses, with a significant increase in the latter part of the study period.
- Candida species were the predominant pathogens, though unusual fungi like Candida parapsilosis, Torulopsis candida, and Aspergillus restrictus were also identified.
- Infected venous catheter thrombosis was a probable source in 5 of 12 identified cases.
- Fungal infections presented as endocarditis (primarily left-sided) or myocarditis, with myocarditis often resulting from disseminated infections in immunocompromised individuals.
- Endocarditis frequently complicated surgical interventions.
Impact:
- Highlights the rising threat of fungal cardiac infections, necessitating heightened clinical awareness.
- Underscores the importance of microbiological sampling from relevant sites for accurate diagnosis.
- Provides insights into the pathogenesis and risk factors associated with heart mycoses, particularly in surgical and immunocompromised patients.