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Recurrent prosthetic valve endocarditis caused by Aspergillus delacroxii (formerly Aspergillus nidulans var.

Gábor Balázs Uhrin1, Rasmus Hare Jensen2, Eva Korup3

  • 1Department of Clinical Microbiology, Aalborg University Hospital, Hobrovej 18-22, DK-9000 Aalborg, Denmark.

Medical Mycology Case Reports
|February 25, 2016
PubMed

Insights

Aspergillus delacroxii caused recurrent prosthetic valve endocarditis and fungemia in a patient. Despite surgery and antifungal treatment, the infection led to severe complications, highlighting the challenges in managing fungal endocarditis.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Cardiovascular Surgery

Background:

  • Prosthetic valve endocarditis (PVE) is a serious complication following cardiac valve replacement surgery.
  • Fungal PVE is rare but associated with high morbidity and mortality.
  • Aspergillus species are opportunistic pathogens that can cause invasive infections.

Purpose of the Study:

  • To report a case of recurrent prosthetic valve endocarditis caused by Aspergillus delacroxii.
  • To highlight the diagnostic and therapeutic challenges in managing fungal PVE.

Main Methods:

  • Case report detailing clinical presentation, surgical intervention, and antifungal therapy.
  • Identification of the causative agent, Aspergillus delacroxii, from clinical samples.

Main Results:

  • The patient developed recurrent PVE due to Aspergillus delacroxii, identified as the sole pathogen.
  • Abscess formation necessitated mechanical aortic valve conduit replacement.
  • Despite aggressive treatment, the patient experienced a cerebral hemorrhage, indicating persistent fungemia.

Conclusions:

  • Aspergillus delacroxii can cause severe and recurrent prosthetic valve endocarditis.
  • Management requires a multidisciplinary approach involving early diagnosis, aggressive surgical intervention, and prolonged antifungal therapy.
  • Fungal PVE poses a significant challenge, often leading to poor outcomes.
Keywords:
Aspergillus delacroxiiAspergillus nidulans var. echinulatusBioprosthesisEndocarditisSurgical site infection

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