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Candida myocarditis without valvulitis

W G Franklin, A B Simon, T M Sodeman

    The American Journal of Cardiology
    |December 1, 1976
    PubMed
    Summary
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    Systemic candidiasis can invade the heart, causing arrhythmias and conduction disturbances. Suspect cardiac Candida in young patients with positive blood cultures and new cardiac abnormalities.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Mycology

    Background:

    • Systemic candidiasis is a serious fungal infection.
    • Cardiac involvement in systemic candidiasis is not well-characterized.
    • Valvular endocarditis is a known complication, but myocardial invasion is less understood.

    Purpose of the Study:

    • To investigate the clinical manifestations and outcomes of Candida myocardial invasion in patients with systemic candidiasis.

    Main Methods:

    • Retrospective analysis of postmortem examinations of 31 patients with systemic candidiasis and myocardial Candida involvement.
    • Comparison with 19 patients with systemic candidiasis but without myocardial invasion.
    • Review of clinical courses, focusing on cardiac events and hemodynamic status.

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    Main Results:

    • Candida myocardial invasion was found in 31 postmortem cases.
    • Cardiac abnormalities, including conduction disturbances, arrhythmias, and QRS changes, were frequent in patients with myocardial invasion.
    • Hemodynamic instability (hypotension/shock) occurred in 13 patients, unexplained by other factors.
    • Patients without myocardial invasion had fewer and less severe cardiac changes.

    Conclusions:

    • Candida invasion of the heart significantly complicates systemic candidiasis.
    • Suspect cardiac Candida in young individuals with no prior heart disease presenting with positive Candida cultures and new cardiac abnormalities.
    • The impact of antifungal therapy on Candida myocardial invasion remains unknown.