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Aspergillus endocarditis: a review of the literature

Ameeta S Kalokhe1, Nadine Rouphael, Mikhael F El Chami

  • 1Infectious Diseases, Emory University, 206 Woodruff Research Extension Bldg, 49 Jesse Hill Jr. Drive, Atlanta, GA 30303, USA. akalokh@emory.edu

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|November 2, 2010
PubMed

Insights

Cardiac device-related Aspergillus endocarditis is rare, especially after bone marrow transplant. Early suspicion, diagnosis via histology and culture, and aggressive treatment with surgery and antifungals are crucial for patient outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Transplantation Immunology

Background:

  • Cardiac device infections pose significant challenges, particularly in immunocompromised hosts.
  • Aspergillus endocarditis is a rare but life-threatening complication, often associated with specific risk factors.

Observation:

  • A case of Aspergillus endocarditis in a patient with a pacemaker following an allogeneic bone marrow transplant is presented.
  • Echocardiography revealed a vegetation, while blood cultures remained negative, highlighting diagnostic challenges.

Findings:

  • Diagnosis of Aspergillus endocarditis requires high clinical suspicion in immunosuppressed patients with cardiac device and negative cultures.
  • Confirmation relies on tissue histology and culture, underscoring the need for invasive diagnostics.
  • Optimal management involves a combination of aggressive surgical intervention and extended antifungal therapy.

Implications:

  • This case emphasizes the importance of considering rare fungal infections in immunocompromised patients with cardiac devices.
  • Prompt and aggressive multidisciplinary management, including surgery and prolonged antifungal treatment, is essential for improving survival rates.
  • Further research into early diagnostic markers and optimized therapeutic strategies for Aspergillus endocarditis is warranted.

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