Between 1990 and 2002, 237 hearts were examined at autopsy, including 16 with infective endocarditis; 6 showed fungal endocarditis. The preceding pathology was chronic rheumatic heart disease in 2 patients, one of whom had undergone double valve replacement, 2 patients had been treated for acute lymphoblastic leukemia, and one had protein-energy malnutrition. The underlying cause was unknown in one case. The organisms isolated were Aspergillus in 3 patients, Zygomycota in 1, Candida in 1, and both Candida tropicalis and Aspergillus in 1 patient. Immunosuppressed states are a cause of fungal endocarditis in India, although chronic rheumatic heart disease is the preceding pathology in the majority of patients.
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References
1.
ChoudhuryRGroverAVarmaJKhattriHNAnandISBidwaiPS. Active infective endocarditis observed in an Indian hospital 1981–1991. Am J Cardiol1992; 70: 1453–8.
FriedmanRAStarkeJR. Infective endocarditis. In: GarsonAJrBrickerJTFisherDJNeishSR, editors. The science and practice of pediatric cardiology. 2nd ed.Baltimore: Williams & Wilkins, 1998:759–93.
4.
BayerASScheldM. Endocarditis and intravascular infections. In: MandellGLBennettJEDolinB, editors. Mandell, Donglas and Bennett's principles and practice of infections diseases. Philadelphia: Churchill Livingstone, 2000:857–902.
5.
KarchinerAW. Infections on prosthetic valves and intravascular devices. In: MandellGLBennettJEDolinB, editors. Mandell, Donglas and Bennett's principles and practice of infections diseases. Philadelphia: Churchill Livingstone, 2000:903–17.
6.
KumarK SantoshRadhakrishnanKGBalakrishnanKR. Neurological manifestations of infective endocarditis. In: MurthyJMK, editor. Reviews in neurology. Hyderabad: Indian Academy of Neurology, 1994:41–50.
7.
DhanukaAKMisraUKKalitaJ. Neurologic complications of infective endocarditis. A clinical study. Ann Indian Acad Neurol2001; 4: 3–9.
8.
ReddyCRRMJaganbandhuN. Rheumatic heart disease in Kurnool. Indian Heart J1968; 20: 149–53.
9.
RoySTandonD. Pathology of acute rheumatic fever. Ann Natl Acad Med Sci (India)1972; 8: 99–104.
10.
DattaBNKhattriHNBidwaiPSSuriRKGujralJSAgarwalKC. Infective endocarditis at autopsy in Northern India: a study of 120 cases. Jpn Heart J1982; 23: 329–37.
11.
DattaBNNagraniBKhattriHNSapruRPBidwaiPSSuriRK. Rheumatic heart disease at autopsy: an analysis of 260 cases in Chandigarh. Indian Heart J1978; 30: 39–46.
12.
PadmavatiS. Rheumatic fever and rheumatic heart disease in India. In: YuPNGoodwinJF, editors. Progress in cardiology. Philadelphia: Lea & Febiger, 1987:169–83.
13.
AtkinsonJBRobinowitzMMcAllisterHAFormanMBVirmaniR. Cardiac infections in the immunocompromised host. Cardiol Clin1984; 2: 671–86.
14.
MuebrekeDDLytleBWCosgroveDM. Surgical and long-term antifungal therapy for fungal prosthetic valve endocarditis. Ann Thorac Surg1995; 60: 538–43.
BruschJL. Cardiac infections in the immunosuppressed patient. Infect Dis Clin North Am2001; 15: 613–38.
17.
RifkindDMarchioroTLSchneckSAHillRBJrSystemic fungal infections complicating renal transplantation and immunosuppressive therapy. Clinical, microbiological, neurological and pathological features. Am J Med1967; 43: 28–38.
18.
OddsFC. Candida endocarditis, myocarditis and other cardiovascular Candida infections. In: Anonymous. Candida and candidosis. A review and bibliography. 2nd ed.London: Bailliere-Tindall1988;175–80.
19.
GersonSLTalbotGHHurwitzSStromBLLuskEJCassilethPA. Prolonged granulocytopenia: the major risk factor for invasive pulmonary aspergillosis in patients with acute leukemia. Ann Intern Med1984; 100: 345–51.
20.
SchettGCasatiBWillingerBWeinlanderGBinderTGrabenwogerF. Endocarditis and aortal embolization caused by Aspergillus terreus in a patient with acute lymphoblastic leukemia in remission: diagnosis by peripheral-blood culture. J Clin Microbiol1998; 36: 3347–51.
21.
GoodmanJLWinstonDJEldRA GreenfiChandrasekarPHFoxBKaizerH. A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation. N Engl J Med1992; 326: 845–51.
22.
VirmaniRConnorDHMcAllisterHA. Cardiac mucormycosis. A report of five patients and review of 14 previously reported cases. Am J Clin Pathol1982; 78: 42–7.
23.
TuderRM. Myocardial infarct in disseminated mucormycosis. Case report with special emphasis on the pathogenic mechanisms. Mycopathologia1985; 89: 81–8.
