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ABSTRACT: 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.
SUBMITTER: Basyal B
PROVIDER: S-EPMC10170530 | biostudies-literature | 2023 May
REPOSITORIES: biostudies-literature
Basyal Binaya B Clark Paul A PA Cohen Jeffrey E JE Srichai Monvadi B MB
European heart journal. Case reports 20230424 5
<h4>Background</h4><i>Aspergillus</i> endocarditis is a rare cause of infective endocarditis and requires high index of suspicion for diagnosis.<h4>Case summary</h4>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 ...[more]