Aspergillus aortitis in an immunocompetent patient presenting with acute endophthalmitis

Area of Science:

• Infectious Diseases
• Cardiology
• Ophthalmology

Background:

• Aspergillus is a common mold, typically causing infection in immunocompromised individuals.
• Angioinvasive aspergillosis, particularly aortitis, is a rare but serious complication, especially following cardiac surgery.
• Endogenous endophthalmitis is an intraocular infection that can result from systemic spread of pathogens.

Purpose of the Study:

• To report a unique case of angioinvasive Aspergillus aortitis presenting as endogenous endophthalmitis in an immunocompetent patient.
• To emphasize the diagnostic challenges and the importance of considering this diagnosis in specific patient populations.
• To highlight the potential link between prior cardiac surgery and the development of Aspergillus aortitis.

Main Methods:

• Case presentation of an immunocompetent patient with endogenous endophthalmitis.
• Systemic investigation revealing an ascending aortic pseudoaneurysm.
• Surgical resection of the pseudoaneurysm and pathological examination confirming angioinvasive Aspergillus aortitis.

Main Results:

• The patient, despite being immunocompetent, developed endogenous endophthalmitis.
• An ascending aortic pseudoaneurysm was identified as the source of infection.
• Pathology confirmed angioinvasive Aspergillus aortitis, a rare finding in this clinical context.
• The patient had a history of recent cardiac surgery, a known risk factor.

Conclusions:

• Aspergillus aortitis can present atypically, even as endogenous endophthalmitis in immunocompetent patients.
• Early diagnosis and prompt treatment are critical due to the high mortality rate associated with this condition.
• Clinicians should consider angioinvasive Aspergillus infections in patients with prior cardiac surgery who present with unexplained embolic phenomena.