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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Aspergillus mural endocarditis presenting with multiple cerebral abscesses.

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  • 1University of Cincinnati Department of Radiology, 234 Goodman Street, Cincinnati, OH, 45267, USA.

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Mycology

Background:

  • Fungal endocarditis is a rare, lethal cardiac infection, often affecting immunocompromised individuals.
  • A subset of patients present with mural masses unrelated to native valves or devices.
  • This case focuses on diagnosing and managing such a rare presentation.

Observation:

  • A 70-year-old female presented with cerebral abscesses and a left ventricular (LV) inferior wall mass.
  • Echocardiography identified the LV mass.
  • Surgical resection revealed an Aspergillus vegetation on the LV wall, without valve involvement.

Findings:

  • Surgical findings confirmed Aspergillus vegetation as a mural mass.
  • The patient received antifungal therapy post-surgery.
  • Despite treatment, the patient expired 30 days post-therapy initiation.

Implications:

  • Highlights the importance of considering fungal endocarditis in specific clinical scenarios.
  • Emphasizes the need for prompt diagnosis and workup in suspected cases, especially with culture-negative fevers or embolic events.
  • Underscores that early antifungal therapy combined with aggressive surgical debridement offers the best chance of survival.