title: Fungal myocarditis in a preterm neonate.
abstract: A male infant born at 25 weeks gestation presented with abdominal distension, was transferred to our institution for surgical management following suspected bowel perforation with severe sepsis. Umbilical catheter cultures grew Candida parapsilosis. At laparotomy, there was a large ileal perforation with peritonitis, he was treated with amphotericin, antibiotics and had an ileostomy. He had persistent pulmonary hypertension, requiring nitric oxide and high-frequency oscillatory ventilation. Serial echocardiograms revealed a patent ductus arteriosus (PDA), but also demonstrated increasing left ventricular hypertrophy and the development of bright areas within the septal myocardium. Further bright areas developed over a course of 2 weeks in his right ventricular outflow tract. After treatment for candidal infection, there was improvement in left ventricular thickness and brightness of the echogenic lesions was reduced. Biopsy of the lesions was discounted due to the risk of the procedure, the size of the infant and his improving clinical status.
authors.affiliation: Department of Cardiology, The John Radcliffe Hospital, Oxford, Oxfordshire, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Harris
authors.forename: Srinivas
authors.initials: S
authors.lastname: Ananth Narayan
authors.forename: Elizabeth Ann
authors.initials: EA
authors.lastname: Orchard
mesh_terms: D002177:Candidiasis / Q000175:diagnosis*; D003428:Cross Infection / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004452:Echocardiography; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis*; D008297:Male; D009205:Myocarditis / Q000175:diagnosis*