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[Right endocarditis in disseminated aspergillosis].
Annales De Medecine Interne
|January 1, 1985
Summary
A rare case of invasive aspergillosis complicated right heart endocarditis in an immunocompromised patient with lung cancer highlights unusual infection routes. This emphasizes the need to consider non-pulmonary origins for disseminated fungal infections.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Pulmonology
Background:
- Anaplastic bronchial carcinoma can predispose patients to opportunistic infections.
- Invasive aspergillosis is a serious complication, particularly in immunocompromised individuals.
- Right heart endocarditis due to Aspergillus is exceptionally rare.
Observation:
- A 53-year-old man with lung cancer developed septic shock and respiratory distress following a staphylococcal infection.
- Autopsy revealed disseminated aspergillosis affecting the lungs, heart, brain, and kidneys.
- A rare case of right heart aspergillous endocarditis without cardiac valve lesions was identified.
Findings:
- The patient was in an "immunodepressed" state, typical for pulmonary aspergillosis.
- The unusual endocardial and pseudo-miliary pulmonary lesions suggested an extra-pulmonary Aspergillus infection (cutaneous or intravenous).
- This contrasts with typical pulmonary aspergillosis and aspergillous left heart endocarditis post-cardiac surgery.
Implications:
- This case suggests that cutaneous or intravenous routes may be underrecognized portals of entry for invasive aspergillosis.
- The findings challenge conventional understanding of aspergillosis dissemination patterns.
- Further investigation into non-pulmonary infection sources is warranted for invasive aspergillosis management.