Rare case of infective endocarditis from invasive aspergillosis encasing the pulmonary valve: a case report. - 2023

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. Copyright © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.


English

2514-2119

10.1093/ehjcr/ytad218 [doi] PMC10170530 [pmc] ytad218 [pii]

--Automated


MedStar Heart & Vascular Institute
MedStar Washington Hospital Center


Cardiovascular Disease Fellowship
Medicine/Pulmonary-Critical Care


Case Reports