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Aspergillus coronary embolization causing acute myocardial infarction
M Laszewski1, M Trigg, P de Alarcon
1Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City 52242.
Abstract:
An increased frequency of disseminated aspergillosis has been observed in the last decade, mostly occurring in immunocompromised patients including the bone marrow transplant population. Cardiac involvement by Aspergillus remains rare. We report the clinical and postmortem findings of an unusual case of Aspergillus pancarditis in a 7-year-old bone marrow transplant patient with Aspergillus embolization to the coronary arteries leading to a massive acute myocardial infarction. This case suggests that myocardial injury secondary to disseminated aspergillosis should be included in the differential diagnosis of chest pain in the immunocompromised pediatric patient.
Insights
Disseminated aspergillosis, a fungal infection, rarely affects the heart. This case highlights Aspergillus pancarditis and coronary embolization causing myocardial infarction in a pediatric bone marrow transplant patient.
Area of Science:
- Medicine
- Cardiology
- Infectious Diseases
Background:
- Disseminated aspergillosis is increasingly observed in immunocompromised individuals, particularly bone marrow transplant recipients.
- Cardiac involvement by Aspergillus species is a rare but serious complication.
Observation:
- A 7-year-old patient, post-bone marrow transplant, presented with disseminated aspergillosis.
- The patient experienced Aspergillus embolization to the coronary arteries.
Findings:
- The case involved Aspergillus pancarditis, affecting all layers of the heart.
- Coronary artery embolization resulted in a massive acute myocardial infarction.
Implications:
- Myocardial injury due to disseminated aspergillosis should be considered in immunocompromised children with chest pain.
- This case underscores the importance of considering rare cardiac complications in pediatric transplant patients with invasive fungal infections.