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Successful treatment of Aspergillus prosthetic valve endocarditis with oral voriconazole

Lisa J Reis1, Todd D Barton, Alberto Pochettino

  • 1Hospital of The University of Pennsylvania, Philadelphia, PA, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|August 5, 2005
PubMed

Insights

Aggressive treatment for Aspergillus endocarditis, including surgery and voriconazole, can lead to long-term recovery. This case study highlights a successful outcome in a patient with prosthetic valve endocarditis and multiple embolic events.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Mycology

Background:

  • Aspergillus endocarditis, particularly with prosthetic valves, presents significant treatment challenges.
  • Embolic complications, especially in the central nervous system, are associated with a very poor prognosis.

Observation:

  • A patient with prosthetic valve endocarditis caused by Aspergillus fumigatus experienced embolic events affecting the brain, eye, and lower extremities.
  • The infection proved refractory to standard treatments, necessitating aggressive intervention.

Findings:

  • A multidisciplinary approach involving extensive surgical debridement of infected sites and replacement of the aortic valve and root was performed.
  • Long-term oral voriconazole therapy was administered post-operatively.

Implications:

  • This case demonstrates that a combination of aggressive surgical management and targeted antifungal therapy can achieve a cure in complex Aspergillus endocarditis cases.
  • Successful outcomes are possible even in patients with widespread embolic disease, offering hope for similar challenging clinical scenarios.

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