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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
Summary
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.
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