Rare case of infective endocarditis from invasive aspergillosis encasing the pulmonary valve: a case report
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Updated: Jul 30, 2025

Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
Binaya Basyal1, Paul A Clark1, Jeffrey E Cohen1
1Medstar Georgetown University Hospital, Washington Hospital Center, 110 Irving St NW, Washington DC, 20010, USA.
Background:
Aspergillus endocarditis is a rare cause of infective endocarditis and requires high index of suspicion for diagnosis.
Case Summary:
We describe a case of a 50-year-old man with history of metastatic thymoma on immunosuppression (gemcitabine and capecitabine) who presented with progressive dyspnoea. Echocardiography and computed tomography (CT) of chest showed filling defect in the pulmonary artery. The initial differential diagnosis was of pulmonary embolism and metastatic disease. The mass was subsequently excised, which revealed a diagnosis of Aspergillus endocarditis of the pulmonary valve. Unfortunately, he passed away despite medical treatment with antifungal therapy after surgery.
Discussion:
Aspergillus endocarditis should be suspected in immunosuppressed hosts with negative blood cultures and large vegetations on echocardiography. Diagnosis is made by tissue histology but may be difficult or delayed. Optimal treatment involves aggressive surgical debridement and prolonged antifungal therapy; prognosis is poor with high mortality.
Insights
Aspergillus endocarditis is a rare fungal infection of the heart valve, often seen in immunocompromised patients. Early diagnosis and aggressive treatment are crucial but carry a poor prognosis.
Area of Science:
- Mycology
- Cardiology
- Infectious Diseases
Background:
- Aspergillus endocarditis is a rare but serious form of infective endocarditis.
- It predominantly affects immunocompromised individuals.
- A high index of suspicion is necessary for timely diagnosis.
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