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

MedStar author(s):

Basyal, Binaya

, MWHC

, Cardiovascular Disease Fellowship

Citation: European Heart Journal. Case Reports. 7(5):ytad218, 2023 May.PMID: 37181467Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Cardiovascular Disease Fellowship | Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Case ReportsSubject headings: Year: 2023 ISSN:

2514-2119

Name of journal: European heart journal. Case reportsAbstract: 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 Â© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.All authors: Basyal B, Clark PA, Cohen JE, Srichai MBFiscal year: FY2023 Digital Object Identifier:

https://dx.doi.org/10.1093/ehjcr/ytad218

ORCID:

https://orcid.org/0000-0003-1783-9948

Date added to catalog: 2023-06-26

Holdings ( 1 )
Title notes ( 4 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	37181467	Available		37181467

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

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