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Aspergillus flavus endocarditis and meningitis in a child with marfan syndrome

Azam Fattahi1, Shirin Sayyahfar2, Ensieh Lotfali3

  • 1Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.

Current Medical Mycology
|July 1, 2021
PubMed
Abstract

Insights

This case report highlights a rare instance of fungal endocarditis caused by fluconazole-resistant Aspergillus flavus in a pediatric patient with Marfan syndrome. Early consideration of fungal infections is crucial, especially in culture-negative endocarditis cases unresponsive to antibiotics.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pediatric Cardiology

Background:

  • Aspergillus species cause approximately 26% of endocarditis cases.
  • Central nervous system aspergillosis has a high mortality rate of 80%.

Observation:

  • A four-year-old female with Marfan syndrome presented with fever of unknown origin.
  • Infectious endocarditis and meningitis were diagnosed.
  • Fluconazole-resistant Aspergillus flavus was identified as the causative agent.

Findings:

  • Polymerase chain reaction (PCR) confirmed the Aspergillus species.
  • Antifungal susceptibility testing identified resistance to fluconazole.
  • The patient experienced endocarditis, meningitis, and fever of unknown origin.

Implications:

  • Clinicians should consider fungal endocarditis in blood culture-negative cases, even without typical risk factors.
  • Failure of antibiotic therapy warrants investigation for fungal etiologies.
  • Awareness of rare fungal infections in immunocompromised or syndromic patients is critical.
Keywords:
EndocarditisFluconazoleMeningitisAspergillus flavus

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