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Fatal Prosthetic Valve Endocarditis Due to Aspergillus flavus in a Diabetic Patient

Rozita Jalalian1, Tahereh Shokohi2,3, Roghayeh Mirzakhani4

  • 1Department of Cardiology, Mazandaran University of Medical Sciences, Sari, Iran.

Infection and Drug Resistance
|August 9, 2020
PubMed

Insights

This case report details Aspergillus endocarditis (AE) in a patient with a prosthetic valve. Despite treatment, the patient succumbed, highlighting the critical need for vigilance in managing fungal endocarditis.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Mycology

Background:

  • Aspergillus endocarditis (AE) is a severe complication, particularly in immunocompromised individuals undergoing heart valve surgery.
  • It carries a high mortality rate despite available treatments.

Observation:

  • A rare case of AE occurred in a 60-year-old diabetic woman with a history of redo mitral valve prosthesis.
  • The patient underwent a second redo mitral valve replacement and aortic valve replacement.
  • Blood cultures were negative, but the explanted valve revealed Aspergillus flavus.

Findings:

  • Aspergillus flavus was identified using conventional and molecular techniques.
  • Despite treatment with liposomal amphotericin B, the patient's condition deteriorated, leading to mortality.
  • AE can manifest as a late complication following prosthetic valve replacement.

Implications:

  • Early diagnosis and prompt, selective antifungal therapy are crucial for managing AE.
  • Extended patient follow-up after prosthetic valve surgery is essential.
  • Repeating valve-replacement surgeries may be necessary in complex cases.
Keywords:
Aspergillusantifungalfungal endocarditisprosthetic valve replacement

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