Abstract
Aspergillus endocarditis is a rare infection and reported mainly in immunocompromised hosts. We report a case of mitral valve aspergillus endocarditis with ventricular myocardial invasion, cerebral vasculitis and intracranial fungal aneurysm formation in a patient with hemophagocytic lymphohistiocytosis (HLH). This case illustrates the importance of prompt investigation and treatment of masses seen on an echocardiogram for rare infections such as Aspergillus endocarditis in immunocompromised patients.
Highlights
Fungal endocarditis (FE) accounts for only 1–2% of all cases of infective endocarditis (IE) [1]
We report an extremely rare case of aspergillus endocarditis with left ventricular myocardial invasion, cerebral vasculitis and intracranial fungal aneurysm formation in a patient with hemophagocytic lymphohistiocytosis (HLH)
The risk factors for IE have shifted from rheumatic heart disease [4] to nosocomial infections (> 25%), degenerative valvulopathies (30–40%), prosthetic valves (20%), and implanted cardiac devices (7%) in highincome countries [5]
Summary
Fungal endocarditis (FE) accounts for only 1–2% of all cases of infective endocarditis (IE) [1]. Immunocompromised patients are at especially high risk for systemic fungal infections and endocarditis [2]. Aspergillus endocarditis is extremely rare and accounts for 20–25% of all fungal endocarditis; for patients with invasive disease and subsequent hematogenous spread, mortality rates may reach up to 80–90% even with treatment [3].
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