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08:56

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Pacemaker Associated Aspergillus fumigatus Endocarditis: A Case Report

Wanyuan Chen1,2, Youqi Ji2, Xin Hong2

  • 1Department of Pathology, Cancer Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, People's Republic of China.

Infection and Drug Resistance
|January 27, 2023
PubMed

Insights

Aspergillus endocarditis (AE) is a rare but deadly heart infection. Early diagnosis using fungal markers and prompt surgery with antifungal therapy improved patient survival in this case.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Mycology

Background:

  • Aspergillus endocarditis (AE) is a severe infection often complicating cardiac procedures.
  • Diagnosis is challenging due to non-specific symptoms and sterile blood cultures.

Observation:

  • A 68-year-old male with dilated cardiomyopathy and pacemaker developed recurrent fever after antibacterial treatment failure.
  • Vegetation biopsy revealed Aspergillus fumigatus, confirmed by ITS sequencing.

Findings:

  • The patient experienced side effects from voriconazole but improved with surgery and 42 days of caspofungin.
  • Galactomannan assays and next-generation sequencing are recommended for timely AE diagnosis.

Implications:

  • Early surgical intervention combined with targeted antifungal therapy is crucial for improving survival in Aspergillus endocarditis.
  • This case highlights the importance of considering fungal infections in prosthetic valve endocarditis.
Keywords:
AEAspergillus endocarditisAspergillus fumigatusculturefevervegetation

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