A Review on Fungal Myocarditis: The Agents, Predisposing Factors and Treatments Fungal Myocarditis
Novelty in Biomedicine,
Vol. 11 No. 4 (2023),
20 November 2023
,
Page 170- 179
https://doi.org/10.22037/nbm.v11i4.42249
Abstract
Background and Aim: Myocarditis is an inflammatory disease of the heart muscle. It has many symptoms, from mild chest tenderness to cardiogenic alarm. Fungal myocarditis is a disseminated infection that mostly occurs in immunocompromised patients, especially in the intensive care unit (ICU). It has similar symptoms to coronary disease. The exact diagnosis of fungal myocarditis is complex and may be caused by different fungal agents.
Materials and Methods: A review of the literature on fungal myocarditis using PubMed and Google Scholar was conducted. This review collected case reports of fungal myocarditis from 2010 to 2023 worldwide to provide current prevalence in different sex categories and ages. Case reports were reported from North America, Asia, and Europe.
Results: According to results, Aspergillus myocarditis was more commonly reported in men (71.4 %) and had the highest mortality rate among the other fungi (close to 57%). Generally, there are no case reports from South America, Africa, and Australia. Amphotericin B is the first drug choice for Aspergillus myocarditis. Despite qualifying voriconazole treatment, voriconazole use is still under research and has not been confirmed for childcare. Fungal myocarditis mainly occurs in immunocompromised patients who have been hospitalized in ICU.
Conclusion: Regarding morbidity and mortality rate, myocarditis is an alarming disease. Misinterpreting signs and symptoms with other diseases often make diagnosing this disease complex. Delayed diagnosis often leads to failure of the multiple organs and can directly affect the treatment protocol.
- Myocarditis
- Mycoses
- Mortality
How to Cite
References
Golpour A, Patriki D, Hanson PJ, McManus B, Heidecker B. Epidemiological impact of myocarditis. Journal of clinical medicine 2021;10(4):603.
Caforio AL, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013;34(33):2636-48, 48a-48d. doi: 10.1093/eurheartj/eht210
Kato S, Sakai Y, Okabe A, Kawashima Y, Kuwahara K, Shiogama K, et al. Histology of cardiac sarcoidosis with novel considerations arranged upon a pathologic basis. Journal of Clinical Medicine 2022;11(1):251.
Nosanchuk JD. Fungal myocarditis. Frontiers in Bioscience-Landmark 2002;7(4):1423-38.
Vaideeswar P. Aspergillus pancarditis manifesting as hospital-acquired infection: report of two cases and review of literature. Cardiovasc Pathol 2010;19(6):e253-7. doi: 10.1016/j.carpath.2009.11.003
Sagar S, Liu PP, Cooper LT, Jr. Myocarditis. Lancet 2012;379(9817):738-47. doi: 10.1016/s0140-6736(11)60648-x
Law YM, Lal AK, Chen S, Čiháková D, Cooper LT, Jr., Deshpande S, et al. Diagnosis and Management of Myocarditis in Children: A Scientific Statement From the American Heart Association. Circulation 2021;144(6):e123-e35. doi: 10.1161/cir.0000000000001001
Ammirati E, Frigerio M, Adler ED, Basso C, Birnie DH, Brambatti M, et al. Management of Acute Myocarditis and Chronic Inflammatory Cardiomyopathy: An Expert Consensus Document. Circ Heart Fail 2020;13(11):e007405. doi: 10.1161/circheartfailure.120.007405
Orlowski HL, McWilliams S, Mellnick VM, Bhalla S, Lubner MG, Pickhardt PJ, et al. Imaging spectrum of invasive fungal and fungal-like infections. Radiographics 2017;37(4):1119-34.
Wang X, Bu X, Wei L, Liu J, Yang D, Mann DL, et al. Global, regional, and national burden of myocarditis from 1990 to 2017: a systematic analysis based on the Global Burden of Disease Study 2017. Frontiers in Cardiovascular Medicine 2021;8:692990.
Hayashi A, Kobayashi S, Hisauchi I, Komatsu T, Nakahara S, Sakai Y, et al. Long-term favorable course of aspergillus endo-, myo-, and pericarditis. International Heart Journal 2017;58(6):1020-3.
Al-Abdely HM, Alothman AF, Al Salman J, Al-Musawi T, Almaslamani M, Butt AA, et al. Clinical practice guidelines for the treatment of invasive Aspergillus infections in adults in the Middle East region: Expert panel recommendations. Journal of infection and public health 2014;7(1):20-31.
Yoshino T, Nishida H, Takita T, Nemoto M, Sakauchi M, Hatano M, et al. A report of 2 cases of disseminated invasive aspergillosis with myocarditis in immunocompromised patients. Open J Pathol 2013;3(04):166-9.
Franklin WG, Simon AB, Sodeman TM. Candida myocarditis without valvulitis. The American Journal of CARDIOLOGY 1976;38(7):924-8.
Seki A, Yoshida A, Matsuda Y, Kawata M, Nishimura T, Tanaka J, et al. Fatal fungal endocarditis by Aspergillus udagawae: an emerging cause of invasive aspergillosis. Cardiovascular Pathology 2017;28:14-7.
Bullis SS, Krywanczyk A, Hale AJ. Aspergillosis myocarditis in the immunocompromised host. IDCases 2019;17:e00567.
Creed K, Randhawa N, Test V, Siddiqui S. A CASE OF ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS WITH INFILTRATING EOSINOPHILIC MYOCARDITIS. Chest 2021;160(4):A6.
Mendoza-Palomar N, Melendo-Pérez S, Balcells J, Izquierdo-Blasco J, Martín-Gómez MT, Velasco-Nuño M, et al. Influenza-associated disseminated aspergillosis in a 9-year-old girl requiring ECMO support. Journal of Fungi 2021;7(9):726.
Senel M, Schlensak C, Gawaz MP, Krumm P, Mueller KAL. Myocardial Abscess After Myocarditis: Advantages of Multimodal Imaging Detecting the Rare Case of Fungal Abscess. Case Reports 2023;6:1-3.
Dang-Tran K-D, Chabbert V, Esposito L, Guilbeau-Frugier C, Dédouit F, Rostaing L, et al. Isolated aspergillosis myocardial abscesses in a liver-transplant patient. Case Reports in Transplantation 2014;2014.
Kupsky DF, Alaswad K, Rabbani BT. A rare case of aspergillus pericarditis with associated myocardial abscess and echocardiographic response to therapy. Echocardiography 2016;33(7):1085-8.
Kim HW, Moon MH, Lee JW. Myocardial abscess, a rare form of cardiac aspergillosis. Arch Cardiovasc Dis 2014;107(6-7):415-7.
Xie L, Gebre W, Szabo K, Lin JH. Cardiac aspergillosis in patients with acquired immunodeficiency syndrome: a case report and review of the literature. Archives of pathology & laboratory medicine 2005;129(4):511-5.
Zeng J-H, Liu Y-X, Yuan J, Wang F-X, Wu W-B, Li J-X, et al. First case of COVID-19 complicated with fulminant myocarditis: a case report and insights. Infection 2020;48:773-7.
Ashfaq A, Chapital AB. Emphysematous gastritis in a patient with coxsackie B3 myocarditis and cardiogenic shock requiring veno-arterial extra-corporeal membrane oxygenation. International journal of surgery case reports 2015;14:121-4.
George B, Hager M, Cornea V, O'Connor W, Guglin M. Fulminant necrotizing eosinophilic myocarditis: a case report and comprehensive literature review. The VAD Journal 2016;2(1):26.
Nair HG, Aggarwal A, Naveen R, Marak RS, Agarwal R, Gupta L. Histoplasma pyomyositis in a patient with disseminated histoplasmosis and anti-synthetase syndrome: case-based review of literature. Mediterranean journal of rheumatology 2020;31(3):350.
RATH P, MARAKINI AB, SHRIBER S, DUMFORD D. DISSEMINATED HISTOPLASMOSIS IN THE SETTING OF IMMUNOSUPPRESSION DUE TO CROHN DISEASE. Chest 2022;162(4):A1120.
Scott BL, Sherwin JI, Rehder KJ, Campbell MJ, Ozment CP. Histoplasmosis myocarditis in an immunocompetent host after a recreational mud run. Pediatrics 2018;141(Supplement_5):S462-S5.
Barrera-Ramirez C, Diaz-Castano A, Ilarraza-Lomelí H. Isolated Cardiac Cryptococcosis in an Immunocompetent Host. Clin Image Case Rep J 2020; 2 (3): 116 Clin Image Case Rep J 2020; 2 (3): 116 www literaturepublishers org;2:10-40.
Broadfoot BG, Kumarapeli AR. Pheochromocytoma Multisystem Crisis and Masquerading Disseminated Histoplasmosis in a Neurofibromatosis Type 1 Patient With Bilateral Adrenal Tumors. Academic Forensic Pathology 2020;10(1):62-8.
Murty OP. Giant cell myocarditis with cardiac tamponade: a rare combination. The American Journal of Forensic Medicine and Pathology 2008;29(3):245-8.
van der Stoep JH, Sigstad E, Bredberg A. Sarcoidosis with cryptococcal infection apparently engaging only immune-privileged body compartments: a case report. BMC Infectious Diseases 2020;20(1):1-5.
Goico A, Henao J, Tejada K. Disseminated blastomycosis in a 36-year-old immunocompetent male from Chicago, IL. Oxford Medical Case Reports 2018;2018(10):omy071.
Keverline K. Case Report: 44-Year-Old Male with Shortness of Breath, Cough, and Weight Loss. Carolina Journal of Interdisciplinary Medicine 2021;1(1):73–7-–7.
Monika P, Chandraprabha M. Risks of mucormycosis in the current Covid-19 pandemic: a clinical challenge in both immunocompromised and immunocompetent patients. Molecular Biology Reports 2022;49(6):4977-88.
Mita A, Hirano S, Uehara T, Uehara K, Ohno Y, Kubota K, et al. Fatal disseminated mucormycosis due to Cunninghamella bertholletiae infection after ABO-incompatible living donor liver transplantation: a case report. Surgical Case Reports 2022;8(1):1-7.
Markaki L, Spernovasilis N, Lempidakis D, Kokorakis E, Gialamas I, Petousis S, et al. Non-typhoidal Salmonella myocarditis in an immunocompetent young adult with diarrhea. Pan Afr Med J 2019;34:117. doi: 10.11604/pamj.2019.34.117.19506
Villablanca P, Mohananey D, Meier G, Yap JE, Chouksey S, Abegunde AT. Salmonella Berta myocarditis: Case report and systematic review of non-typhoid Salmonella myocarditis. World J Cardiol 2015;7(12):931-7. doi: 10.4330/wjc.v7.i12.931
AlFraih OM, AlAbdulhai MA, Qahtani YA, Al Maimon H, Khan MT, Ihsan E, et al. Pericardial and pulmonary actinomycosis, simulating inflammatory myofibroblastic tumor: the role of surgery. IJS Short Reports 2022;7(2):e51.
Mahadevappa M, Kulkarni P, Poornima K. Disseminated Actinomycosis presenting as chronic right-heart failure due to right ventricular and pericardial infiltration. JACC: Case Reports 2020;2(12):1992-8.
Coussement J, Lebeaux D, van Delden C, Guillot H, Freund R, Marbus S, et al. Nocardia Infection in Solid Organ Transplant Recipients: A Multicenter European Case-control Study. Clinical Infectious Diseases 2016;63(3):338-45. doi: 10.1093/cid/ciw241
Conville PS, Brown-Elliott BA, Smith T, Zelazny AM. The complexities of Nocardia taxonomy and identification. Journal of clinical microbiology 2018;56(1):e01419-17.
Phichaphop C, Apiwattanakul N, Wanitkun S, Boonsathorn S. Bacterial endocarditis caused by actinomyces oris: first reported case and literature review. Journal of Investigative Medicine High Impact Case Reports 2020;8:2324709620910645.
Nishizawa S, Anan K, Tobino K, Okahisa M, Goto Y, Murakami K, et al. Pulmonary Actinomycosis attributable to Actinomyces meyeri presenting as cardiac tamponade: a case report. Multidisciplinary Respiratory Medicine 2018;13:1-5.
Frankel ES, Hajduczok AG, Rajapreyar IN, Brailovsky Y. Recurrent giant cell myocarditis after heart transplant: a case report. European Heart Journal-Case Reports 2022;6(9):ytac362.
- Abstract Viewed: 73 times
- PDF Downloaded: 70 times