Histological detection of intramyocardial abscesses in Candida sepsis mimicking left ventricular non‐compaction/hypertrabeculation on echocardiography

Abstract

Left ventricular non-compaction/hypertrabeculation (LVHT) is a rare cardiac abnormality characterized by more than three trabeculations protruding from the left ventricular wall, apically to the papillary muscles, visible in one echocardiographic image plane and intertrabecular spaces, perfused from the ventricular cavity. LVHT is frequently associated with neuromuscular disorders. Differential diagnoses of LVHT are intraventricular thrombi, false tendons, aberrant bands, intramyocardial hematoma, cardiac metastases and the apical type of hypertrophic cardiomyopathy. Intramyocardial abscesses have not been reported as a differential diagnosis of left ventricular non-compaction. In the presented case, cardiac microabscesses as a result of Candida sepsis mimicked left ventricular non-compaction in a 55-year-old man with hypopharyngeal carcinoma who died 20 days after chemotherapy. These microabscesses were not visible on echocardiography but were detected only at histologic examination of the myocardium. This case shows that intramyocardial abscesses as a result of Candida sepsis are a rare differential diagnosis of LVHT.