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Delayed Diagnosis of Disseminated Invasive Aspergillosis with Purulent Myocarditis in an Immunocompromised Host.

Infect Dis Rep

November 2024

Department of Internal Medicine and Infectious Diseases, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.

Invasive aspergillosis (IA) is an opportunistic fungal infection that typically occurs in the immunocompromised host and is associated with severe morbidity and mortality. Myocardial abscess formation is seldomly described. We present a case of IA with purulent myocarditis.

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Article Synopsis
  • Continuous electrocardiographic (ECG) monitoring during surgery in infants and children is essential to detect potential myocardial pathologies, despite the rarity of these issues in pediatric patients.
  • A case is presented involving a 2-year-old child who showed ST segment depression and increased R wave amplitude during surgery, which led to the discovery of undiagnosed hypertrophic cardiomyopathy postoperatively.
  • The findings emphasize the importance of recognizing ECG changes and the need for thorough evaluation to prevent complications during and after surgery, even when patients appear asymptomatic.
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In an endemic region for acute rheumatic fever, the suspicion of myocarditis origin had also to be directed into rheumatic etiology. We present a case of a 10-year-old patient with subacute fever and myocardial systolic dysfunction (ejection fraction: 25%). One week after treatment, recovery of systolic function was observed.

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Background: Fulminant eosinophilic myocarditis (EM) is a rare and often fatal condition that may present atypically and be complicated by ventricular arrhythmias. Treatment involves high-dose corticosteroids to suppress eosinophilia, as well as increasing use of mepolizumab, an anti-interleukin-5 antibody with evidence for long-term efficacy and safety.

Case Summary: A 38-year-old woman presented to the emergency department with neck pain and fatigue, and after extensive investigation was diagnosed with EM secondary to idiopathic hypereosinophilic syndrome.

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Background: Nonbacterial thrombotic endocarditis (NBTE) is an uncommon and often underdiagnosed condition characterized by a state of hypercoagulability. We present a case of a patient with ulcerative colitis who experienced a non-ST-segment elevation myocardial infarction as a rare complication of NBTE.

Case Summary: We report a case of a 16-year-old male with a history of ulcerative colitis who presented to the emergency department with chest pain at rest.

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