Actinomycosis of the Heart Simulating Rheumatic Fever

Actinomycosis is the most common visceral mycotic infection in man. As early as 1899, ten years after the first description of the disease in man by Israel, Ruhrah1presented statistics on 1,094 cases. In 1925 Sanford and Voelker2were able to collect reports of 670 cases in the United States alone. In about 15 per cent of these cases the infection occurred in the thorax. This figure has been corroborated by other observers, but, as pointed out by Kaufmann,3involvement of the heart and pericardium is distinctly rare. Kasper and Pinner4found it to occur in less than 2 per cent of 470 cases of actinomycosis. In his recent excellent monograph on actinomycosis Cope5made only one general statement concerning cardiac actinomycosis, namely, extension by continuity may take the fungus into the pericardium or the very substance of the heart. The following case is an