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Rapidly advancing invasive endomyocardial aspergillosis
Vedat Davutoglu1, Serdar Soydinc, Abdullah Aydin
1Departments of Cardiology and Pathology, Gaziantep University School of Medicine, Sahinbey Medical Center, TR-27310 Sahinbey/Gaziantep, Turkey. davutoglu@gantep.edu.tr
Summary
Invasive endomyocardial aspergillosis, a rare fungal infection, occurred in a non-immunocompromised patient due to prolonged broad-spectrum antibiotic use. This case highlights the risk of opportunistic fungal infections in unexpected patient populations.
Area of Science:
- Mycology
- Infectious Diseases
- Cardiology
Background:
- Aspergillus spore exposure is common, but invasive disease typically affects immunocompromised individuals.
- Broad-spectrum antibiotic use can disrupt the microbiome, potentially increasing susceptibility to opportunistic infections.
Observation:
- A 36-year-old cotton textile worker presented with weight loss and fatigue after prolonged antibiotic treatment.
- Echocardiography revealed endomyocardial vegetations and a left atrial mass.
- Myocardial biopsy confirmed invasive endomyocardial aspergillosis.
Findings:
- The patient was non-immunocompromised, with negative investigations for immune deficiency including HIV.
- Treatment with amphotericin B and heparin was initiated.
- The patient succumbed to a ruptured mycotic aneurysm leading to cerebral hemorrhage.
Implications:
- This case underscores the potential for invasive fungal infections, such as aspergillosis, in non-immunocompromised hosts with prolonged antibiotic exposure.
- Environmental exposure to Aspergillus, combined with antibiotic-induced dysbiosis, may create a risk for opportunistic infections.
- Highlights the need for vigilance regarding fungal infections in patients with atypical risk factors.