Diagnosis at first glance: hairy black colonies in resected prosthetic aortic valve

Kocazeybek, Bekir; Sönmez, Bingür; Şarman, K.; Şener, Deniz; Özdemirli, M.; Aytekin, Saide; Ayyıldız, Aylin Çimet; Demiroglu, Cemsid

doi:10.1046/j.1469-0691.2000.00138.x

Cited by 4 publications

(2 citation statements)

References 4 publications

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“…summarises some clinical details for 124 patients with Aspergillus endocarditis or aortitis following heart surgery [4,8–91]. The median age of these patients was 43.5 (range 0.8–71) years.…”

Section: Literature Reviewmentioning

confidence: 99%

Post-operative aspergillosis

Pasqualotto

Denning

2006

Clinical Microbiology and Infection

156

173

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While invasive aspergillosis occurs typically in severely immunocompromised patients, cases of surgical site infection have been reported in immunocompetent individuals. The Medline, LILACS and EMBASE databases were searched for descriptions of cases of post-operative aspergillosis, and references from relevant articles and conference abstracts were reviewed. More than 500 cases of post-operative aspergillosis were found. Cardiac surgery (n = 188), ophthalmological surgery (n > 90) and dental surgery (n > 100) were associated with the majority of cases. Other cases involved wound infections (n = 22), bronchial infections (n = 30), mediastinitis (n = 11), pleural aspergillosis (n = 1), infections following orthopaedic surgery (n = 42), vascular prosthetic surgery (n = 22), breast surgery (n = 5), abdominal surgery (n = 10) and neurosurgery (n = 25). In most patients, the source was presumed to be airborne infection during the surgical procedure. Prevention of these infections requires special care of the ventilation system in the operating room. Successful treatment requires rapid diagnosis, surgical debridement and antifungal therapy, often with voriconazole. In order to improve the outcome, better diagnostic methods are needed, particularly for cases of endocarditis and aortitis.

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Section: Literature Reviewmentioning

confidence: 99%

Post-operative aspergillosis

Pasqualotto

Denning

2006

Clinical Microbiology and Infection

156

173

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“…While Aspergillus fumigatus represents the major cause of Aspergillus endocarditis and invasive aspergillosis in general, Aspergillus niger and other Aspergillus spp. of section Nigri account for some cases [5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Indeed, Aspergillus niger is ubiquitous in the environment and has been recognized as a relatively frequent contaminant of hospital indoor environment (e.g.…”

Section: Introductionmentioning

confidence: 99%

Aspergillus tubingensis Endocarditis: A Case Report and Review of the Literature

et al. 2022

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Aspergillus endocarditis is a rare infection that may affect immunocompetent patients following heart valve replacement or heart surgery. We report the case of a 39 year old woman with a history of intravenous drug use who developed endocarditis with direct examination of the resected valve and vegetation showing the presence of mycelia. Cultures were positive for an Aspergillus of section Nigri, which was subsequently identified as Aspergillus tubingensis by sequencing. The clinical course was favorable following surgery and prolonged antifungal therapy (8 months in total). Antifungal susceptibility testing showed good in vitro activity of amphotericin B, voriconazole and echinocandins against planktonic cells of this A. tubingensis isolate. However, only amphotericin B displayed significant activity against biofilms. In vitro combinations of voriconazole or amphotericin B with echinocandins did not meet the criteria of synergism. Our review of the literature identified 17 other cases of endocarditis attributed to Aspergillus of section Nigri with an overall mortality rate of 57% (100% in the absence of surgery). Endocarditis caused by Aspergillus niger and related cryptic species are rare events, for which surgical management appears to be crucial for outcome. While amphotericin B was the only antifungal drug displaying significant anti-biofilm activity, the type and duration of antifungal therapy remain to be determined.

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Aspergillus endocarditis: a review of the literature

Kalokhe

Rouphael

El‐Chami

et al. 2010

International Journal of Infectious Diseases

100

164

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We present a case of cardiac device-related Aspergillus endocarditis in a patient with a pacemaker and an allogeneic bone marrow transplant to segue into a review of the Aspergillus endocarditis literature. Aspergillus endocarditis should be suspected in patients with underlying immunosuppression, negative cultures, and a vegetation on echocardiography. Diagnosis ultimately requires confirmation by tissue histology and culture. The optimal treatment approach often requires aggressive surgical debridement in conjunction with prolonged antifungal therapy.

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Diagnosis at first glance: hairy black colonies in resected prosthetic aortic valve

Cited by 4 publications

References 4 publications

Post-operative aspergillosis

Post-operative aspergillosis

Aspergillus tubingensis Endocarditis: A Case Report and Review of the Literature

Aspergillus endocarditis: a review of the literature

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