Two Cases of Aspergillus Endocarditis in Non Neutropenic Children on Chemotherapy for Acute Lymphoblastic Leukaemia

Emmanouil Nikolousis,Mark Velangi

doi:10.4081/hr.2011.e7

Abstract

Fungal endocarditis (FE) is a rare complication in immunocompromised patients which is difficult to diagnose and has been characterized by excessive mortality (> 50%) and morbidity, regardless of treatment. The lack of clinical trials due to the small number of cases contributes further to a poor outcome. In our two cases of aspergilllus endocarditis we reviewed the clinical features, echocardiographic findings, microbiologic data, treatment, and outcome of these 2 cases and provide a current characterization of the syndrome. In this paper we have demonstrated the diversity of presentation of a critical fungal infection in immunocompromised but non neutropenic paediatric patients. The prompt diagnosis and initiation of treatment is crucial for a favourable outcome along with the use of double antifungal treatment with liposomal amphotericin and voriconazole initially which could be later switched to oral voriconazole with a good tissue penetration. Histological samples as well as radiological evidence and echocardiograms should be reviewed by experienced clinicians in order to aid diagnosis and promptly initiate treatment for these patients in order to achieve a favourable outcome

Highlights

Fungal endocarditis (FE) is a rare complication in immunocompromised patients which is difficult to diagnose and has been character
The prompt ia diagnosis and initiation of treatment is crucial for a favourable outcome along with the use of rc double antifungal treatment with liposomal amphotericin and voriconazole initially which e could be later switched to oral voriconazole m with a good tissue penetration
Histological samples as well as radiological evidence and m echocardiograms should be reviewed by experienced clinicians in order to aid diagnosis and o promptly initiate treatment for these patients -c in order to achieve a favourable outcome Non Introduction she was admitted with ongoing pyrexia, tachycardia, rigors and a blanching rash on the left thigh

Summary

Introduction

Fungal endocarditis (FE) is a rare complication in immunocompromised patients which is difficult to diagnose and has been character-. The prompt ia diagnosis and initiation of treatment is crucial for a favourable outcome along with the use of rc double antifungal treatment with liposomal amphotericin and voriconazole initially which e could be later switched to oral voriconazole m with a good tissue penetration.

Results

Conclusion