Abstract
Abstract Background Disseminated Aspergillus infection is a severe condition in immunocompromised patients. Mortality secondary to cardiac Aspergillus infection remains high. Case summary We present a case of a 45-year-old female breast cancer patient who developed Aspergillus fumigatus endocarditis and myocarditis after receiving the immune checkpoint inhibitor (ICI) pembrolizumab. The infection emerged as a complication following the management of a severe immune-related adverse event (irAE) with high doses of immunosuppressants, triggered by the ICI. Discussion The use of ICI and the subsequent treatment of irAEs with immunosuppressants introduces a new subset of immunocompromised patients at risk for fungal infections. While alternative corticosteroid-sparing immune-modulating agents such as biologicals, intravenous immunoglobulins (IVIGs) and disease modifying antirheumatic drugs have been explored, there is lack of prospective studies evaluating their efficacy and safety in this context.
Published Version
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