CARDIAC FUNGAL-INFECTIONS - REVIEW OF AUTOPSY FINDINGS IN 60 PATIENTS

An autopsy study of 60 patients with fungal infections of the heart was undertaken. The patients ranged in age from 2 mo. to 79 yr. Fifteen of the patients had undergone cardiac surgery; neoplasms were found in 13, renal failure in 8, bacterial infections in 5, liver disease in 5, gastrointestinal disorders in 5, and immune disease in 4; 2 had been i.v. drug abusers; other miscellaneous disorders were observed in 3. The fungal infection was limited to the myocardium in 27 patients and to the endocardium in 17 patients. Myocardium and endocardium were involved in 9 patients and pericardium and myocardium in 5; 2 patients had pericarditis alone. The most frequent organism was Candida (62%). Aspergillus (12%) and Phycomycetes (12%) were also found frequently. In 51 patients (85%) other deep organs, usually lung, kidney, brain or spleen were involved. Cultures for fungus had been positive in 26 patients prior to death, and postmortem cultures were positive in 29 patients. Patients who had undergone cardiac surgery had a higher incidence of endocarditis (93%), with Candida (53%) being the most frequent cause. Patients who had received antineoplastic drugs, antibiotics or corticosteroids had a higher incidence of myocarditis (79%), again most often due to Candida (60%).