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Catastrophic Prosthetic Valve Endocarditis Caused by Rare Black Fungi

Khurram Butt1, Ranjeet Kumar1, Jason D'Souza1

  • 1Florida Hospital, Orlando, USA.

Case Reports in Cardiology
|October 27, 2018
PubMed

Insights

Black fungi rarely cause prosthetic heart valve endocarditis. This case details a prosthetic aortic graft infection in an immunocompetent patient, leading to embolic events and requiring surgical intervention and antifungal therapy.

Area of Science:

  • Cardiology
  • Mycology
  • Infectious Diseases

Background:

  • Fungal endocarditis, particularly by dematiaceous molds (black fungi), is a rare but severe complication of prosthetic heart valves.
  • These infections typically affect immunocompromised individuals and present diagnostic and therapeutic challenges due to limited antifungal options.

Observation:

  • A rare case of prosthetic aortic valve, root, and graft infection by dematiaceous mold in an immunocompetent host.
  • The infection manifested as embolic phenomena affecting the renal, mesenteric, and cerebral circulations.

Findings:

  • Surgical intervention included aortic graft explantation and replacement, along with small bowel resection due to mesenteric infarction.
  • The patient received long-term antifungal treatment with amphotericin B and voriconazole, achieving a successful postoperative outcome.

Implications:

  • This case highlights the potential for dematiaceous mold to cause severe prosthetic heart valve infections even in immunocompetent patients.
  • Successful management requires a multidisciplinary approach involving surgery and targeted antifungal therapy, emphasizing the need for vigilance in diagnosing rare fungal endocarditis.

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