An autopsy case of candidal myocardial abscess in a patient with pneumonia

A 69-year-old man was admitted to our hospital because of acute respiratory failure and pneumonia. Mechanical ventilation was begun, and antibiotics were subsequently administered. Bronchoalveolar lavage fluid showed fresh blood-like fluid containing hemosiderin-laden macrophages. ANCA and Anti GBM Ab were negative. Finally he was diagnosed with alveolar hemorrhage due to severe pneumonia. After receiving corticosteroid and antibiotics, respiratory failure was improved. One week after extubation, he suddenly developed fever and disturbance of consciousness. Candida albicans was detected from blood and cerebrospinal fluid culture. Despite administration of an antifungal agent, his condition worsened and he died five days after developing fever. Microscopic findings of the autopsy revealed candidal myocardial abscess. We encountered a rare autopsy case of candidal myocardial abscess in non-hematologic disease. This is an important case report to investigate how to diagnose fungal infections and treat them immediately.