Fungal endocarditis: review of our cases over a four-year period

Over a 4-year period, we studied six cases of fungal endocarditis, four of which were caused by Aspergillus sp. And the other two were candidal in origin. Both sides of the heart showed involvement by these infections. The vegetations of infective endocarditis tend to vary in size, but fungal lesions are often large. Our youngest patient was four months old and the oldest one was 62 years old. A high index of clinical suspicion, together with histopathological and microbiological studies, can be used as tools to diagnose and treat such patient in due course. It is important to send fresh specimens for tissue culture studies in sterile normal saline and not in fixatives such as formaladehyde. Pathologically, not only are the special staining methods such as Periodic acid-Schiff useful in the demonstration of fungal elements in tissue or vegetation sections, but also the routine hematoxylin and eosin stain is capable of showing these structures clearly

Neglected inferior sinus venosus atrial septal defect diagnosed late after surgical closure of secundum ASD

We descried neglected inferior sinus venosus a trial septal defect in a patient with history of surgical repair of secundum type ASD nineteen years ago. The defect was in the inferior portion of the interatrial septum just at the orifice of the inferior vena cava, far from the previous surgical patch of the secundum ASD repair. Preoperative and/or intraoperative transesophageal echocardiography is necessary for detection of multiple ASDs and reveals the successful repair of sinus venosus defects