Opportunistic Infections
Toxoplasma gondii can produce a gross pattern of patchy irregular white infiltrates in the myocardium, similar to non-Hodgkin’s lymphoma. Microscopically, the myocardium shows scattered mixed inflammatory cell infiltrates with polymorphonuclear leukocytes, macrophages, and lymphocytes.
True Toxoplasma gondii cysts or pseudocysts containing bradyzoites are often hard to find, even if inflammation is extensive. Immunohistochemical staining may reveal free tachyzoites, otherwise difficult to distinguish, within the areas of inflammation. Toxoplasma gondii myocarditis can produce focal myocardial fiber necrosis and heart failure can ensue [40].Other opportunistic infections of the heart are infrequent. They are often incidental findings at autopsy, and cardiac involvement is probably the result of widespread dissemination, as exemplified by
Candida and by the dimorphic fungi Cryptoc- cocus neoformans, Coccidioides immitis, and Histoplasma capsulatum. Patients living in endemic areas for Trypanosoma cruzi may rarely develop a pronounced myocarditis and dilated cardiomyopathy [40].
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