Aspergillus fumigatus endocarditis in a splenectomized patient with no risk factors

Aspergillus endocarditis is a rare cause of culture-negative fungal endocarditis, after Candida endocarditis. Typical risk factors include intravenous drug use, immunosuppression, prior cardiac surgery or presence of prosthetic heart valves, hematopoietic stem cell or solid organ transplantation. Common presentations include signs and symptoms consistent with endocarditis but with negative bacterial blood cultures. Here, we present a case report of a 49-year-old male without known risk factors for fungal endocarditis who presented with a stroke and found to have Aspergillus endocarditis. Despite surgical intervention and antifungal treatment, the outcome was fatal. This underscores the difficulty in diagnosing Aspergillus endocarditis and its poor prognosis, necessitating the need for early diagnosis and intervention.