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Clin. Cardiol. 23, 55 (2000)
Andreas Kirchgatterer, M.D., Johann Auer, M.D., Klaus Täuber, M.D., Reinhard Balon, M.D.,* Bernd Eber, M.D.
Departments of Cardiology and *Pathology, General Hospital Wels, Austria; and Department of Medicine, General Hospital Braunau, Austria
A 67-year-old male patient with a history of splenectomy due to immunohemolytic anemia four months previously, followed by fungal prostatitis, was admitted to a referral hospital with sepsis and progressive dyspnea. Transesophageal echocardiography demonstrated a bulky vegetation on the anterior mitral leaflet (Fig. 1). In spite of extensive antibiotic and antimycotic therapy, the condition of the patient worsened rapidly. He was transferred to our department for mitral valve replacement; however, the patient died one day before surgery due to embolic cerebral infarction. Autopsy revealed a large vegetation attached to the anterior mitral leaflet (Fig. 2). Histology proved fungal endocarditis (Fig. 3).
Fig. 1 Transesophageal echocardiography: bulky vegetation on the anterior mitral leaflet.
Fig. 2 Autopsy: mitral valve endocarditis with destruction of the anterior leaflet.
Fig. 3 Histology: hyphae (culturally proved Candida albicans) infiltrate the vegetation.
Although the entity of fungal endocarditis is not new, the present case is remarkable because of the large dimensions of the vegetation despite parenteral antimycotic therapy. This case represents a reminder of the susceptibility of severely immunodepressed patients to certain infectious agents.
Reference
Address for reprints:
Andreas Kirchgatterer, M.D.
Department of Cardiology
General Hospital Wels
Grieskirchnerstr. 42
A-4600 Wels, Austria
Received: May 11, 1999
Accepted: July 15, 1999