Fatal Prosthetic Valve Endocarditis Due to Aspergillus flavus in a Diabetic Patient

Aspergillus endocarditis (AE) accounts for a-quarter of all fungal endocarditis, mainly in immunocompromised hosts prior to heart-valve surgery with high mortality, even with treatment. Herein, we report a rare case of AE in a diabetic 60-year-old woman with a history of redo mitral valve prosthesis...

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Published inInfection and drug resistance Vol. 13; pp. 2245 - 2250
Main Authors Jalalian, Rozita, Shokohi, Tahereh, Mirzakhani, Roghayeh, Ghasemian, Roya, Hedayati, Mohammad Taghi, Ardalani, Sirus, Azizi, Soheil, Kalhori, Shamsi, Kermani, Firoozeh, Mayahi, Sabah
Format Journal Article
LanguageEnglish
Published Macclesfield Dove Medical Press Limited 31.07.2020
Taylor & Francis Ltd
Dove
Dove Medical Press
Subjects
Amphotericin B
Antibiotics
antifungal
Antifungal agents
Antiparasitic agents
Aortic valve
aspergillus
Aspergillus flavus
Blood clots
Blood tests
Cardiovascular disease
Care and treatment
Case Report
Caspofungin
Coronary vessels
Deoxyribonucleic acid
Diabetes
Diabetes mellitus
Diabetics
DNA
Edema
Endocarditis
fungal endocarditis
Gene amplification
Health aspects
Heart
Hypertension
Immunocompromised hosts
Iran
Laboratories
Literature reviews
Meropenem
Mitral valve
Mortality
Patients
Prostheses
Prostheses and implants
prosthetic valve replacement
Prosthetic valves
Pulmonary arteries
Surgery
Vegetation
Iran
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Summary:Aspergillus endocarditis (AE) accounts for a-quarter of all fungal endocarditis, mainly in immunocompromised hosts prior to heart-valve surgery with high mortality, even with treatment. Herein, we report a rare case of AE in a diabetic 60-year-old woman with a history of redo mitral valve prosthesis suspecious of acute endocarditis. She underwent second redo surgical mitral valve replacement in combination with mechanical aortic valve replacement. Blood cultures were negative. The explanted valve and vegetation were subjected to identification. Grown colonies were identified as Aspergillus flavus, based on conventional and molecular methods. Despite the administration of liposomal amphotericin B and improvement in her general condition shortly after initiation of therapy, the patient passed away. As AE is a late consequence of redo prosthetic valve replacement, extended follow-up, early diagnosis, repeating valve-replacement surgeries, and timely selective antifungal treatments are warranted. Keywords: fungal endocarditis, Aspergillus, antifungal, prosthetic valve replacement
ISSN:1178-6973
1178-6973
DOI:10.2147/IDR.S258637