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Aspergillus endocarditis in chronic granulomatous disease
D H Casson1, F A Riordan, E J Ladusens
1Department of Paediatric Gastroenterology, Royal Free Hospital, London.
Acta Paediatrica (Oslo, Norway : 1992)
|June 1, 1996
Summary
This study details the first known case of Aspergillus endocarditis in chronic granulomatous disease (CGD), complicated by an atrial septal defect. Skin lesions aided diagnosis, suggesting fungal endocarditis as a consideration in CGD patients with heart defects.
Area of Science:
- Mycology
- Infectious Diseases
- Cardiology
Background:
- Chronic granulomatous disease (CGD) is an immunodeficiency disorder predisposing individuals to fungal infections.
- Fungal endocarditis is a rare but serious condition, particularly in immunocompromised patients.
- Atrial septal defects can increase the risk of infective endocarditis.
Observation:
- A unique case of Aspergillus endocarditis is presented in a patient with CGD and an atrial septal defect.
- Diagnosis was confirmed by fungal culture from cardiac mass, following extensive prior investigations.
- Distinctive skin lesions were observed, serving as a potential diagnostic clue for fungemia.
Findings:
- This is the first reported instance of Aspergillus endocarditis in the context of CGD.
- The study highlights the diagnostic utility of skin lesions in identifying fungemia.
- Culture of Aspergillus from the cardiac mass confirmed the diagnosis.
Implications:
- Fungal endocarditis should be suspected in CGD patients, especially those with structural heart defects.
- Advances in diagnosing fungal infections, such as detecting fungal cell wall components, may improve early detection.
- Prophylactic strategies, potentially including itraconazole, warrant further investigation for CGD patients at risk.