Incidence of endomycoses in the autopsy material of the Berlin Charite hospital

From 1970 to 1993, a total of 93 endomycoses confirmed by post-mortem exami nation was diagnosed in the autopsy material of the Berlin Charite, a large hospital with an average of 1,500 hospital beds and maximum medical care. These comprised 51 candidoses (54.8%), 24 aspergilloses (36.6%), five crypt ococcoses (5.4%), one zygomycosis, 1 trichosporosis and one coccidioidomyco ses. This corresponded to 0.7% of the 13,375 deceased persons autopsied dur ing this period. The frequency of autopsy was 85.3%. In 3,770 cases (2,418 adults and 1,352 children), brain dissection was performed. An adequate cli nical putative diagnosis was made in only six out of 28 patients (18 adults , 10 children) with histologically confirmed cerebral mycosis [11 candidose s (39.3%), 10 aspergilloses (35.7%), five cryptococcoses (17.9%), one trich osporosis and one coccidioidomycosis]. About 80% of the mycoses of the CNS thus remained undetected while the patients were alive. Against the backgro und of the continuing reduction in the frequency of autopsy in the Federal Republic of Germany, the observations made in the present paper underscore the demand for improved efficiency of mycological in-vivo diagnoses in the hospital and laboratory.