Fungal myocarditis.

The incidence of invasive fungal disease has dramatically increased over the past few decades corresponding to the rising number of immunocompromised patients. The major risk factors for severe fungal disease include administration of broad-spectrum antibiotics, corticosteroids and cytotoxic agents, invasive medical procedures, and Human Immunodeficiency Virus (HIV) infection. Invasive fungal infections often affect multiple organs, and involvement of the myocardium frequently occurs in disseminated disease. Premortem diagnosis of fungal myocarditis is difficult since clinical findings of myocardial involvement are often absent or ambiguous and blood cultures are often negative. The major fungal pathogens responsible for myocardial infection and the clinical settings in which they occur are reviewed.