Aspergillosis of the Heart and Lung and Review of Published Reports on Fungal Endocarditis

Abstract

Invasive aspergillosis (IA) is increasingly diagnosed in high-risk patients. The lesions are usually located in the lungs and/or sinuses, and the fungus may spread haematogenously to different organs; however, involvement of the heart during IA is very rare. We describe a unique case of invasive aspergillosis of the heart septum and the lungs in the allogeneic haematopoietic stem cell transplant recipient.

Aspergillus flavus native valve endocarditis following combined liver and renal transplantation: Case report and review of the literature

“…Similar to most previously reported cases, our patient's left heart valves were involved . Graft versus host disease (GVHD) requiring at least 2 immunosuppressive medications was present in 4 out of the 6 cases …”

“…Fungal biomarkers such as serum galactomannan may prompt additional investigations targeting a possible fungal etiology. However, of the 5 cases for which galactomannan results were available only 2 were positive . Blood cultures are usually negative in the setting of Aspergillus endocarditis and transthoracic echocardiogram is often negative.…”

“…1,7,8,10,12,[14][15][16][17][18][19][20][21][22][23][24] Graft versus host disease (GVHD) requiring at least 2 immunosuppressive medications was present in 4 out of the 6 cases. 1,7,11,[25][26][27] Aspergillus endocarditis was reported in 23 patients post solid TA B L E 2 (Continued) regimen was reported in 4 out of the 23 cases. 10,13,17,28 CMV infection was reported in 2 cases.…”

Co-infection with bacterial and fungal endocarditis at scar tissue in an immunocompromised patient

“…Invasive aspergillosis is extremely rare in immunocompetent individuals [8]. The lungs and/or sinus are usually affected first, then the fungus spreads hematogenously to other organs; however cardiac involvement is rare [9]. Aspergillus accounts for 24-28% of all cases of FE [10].…”

Invasive Aspergillosis in Transplant Recipients

“…Tissue sections are usually stained with hematoxylin and eosin, but other staining techniques are also used in practice (e.g. Gomori-Grocott methenamine silver stain, periodic acid-Schiff stain) [2,88,89]. Histopathological tissue sections from a patient with invasive easpergillosis of the heart and lung are shown in Sulik-Tyszka et al [89].…”