Fatal Prosthetic Valve Endocarditis Due to Aspergillus flavus in a Diabetic Patient

Rozita Jalalian,1 Tahereh Shokohi,2,3 Roghayeh Mirzakhani,4 Roya Ghasemian,5 Mohammad Taghi Hedayati,2,3 Sirus Ardalani,6 Soheil Azizi,7 Shamsi Kalhori,7 Firoozeh Kermani,4 Sabah Mayahi3 1Department of Cardiology, Mazandaran University of Medical Sciences, Sari, Iran; 2Invasive Fungi Research Centre...

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Main Authors: Jalalian R, Shokohi T, Mirzakhani R, Ghasemian R, Hedayati MT, Ardalani S, Azizi S, Kalhori S, Kermani F, Mayahi S
Format: Article
Language:English
Published: Dove Medical Press 2020-07-01
Series:Infection and Drug Resistance
Subjects:
Online Access:https://www.dovepress.com/fatal-prosthetic-valve-endocarditis-due-to-aspergillus-flavus-in-a-dia-peer-reviewed-article-IDR
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author Jalalian R
Shokohi T
Mirzakhani R
Ghasemian R
Hedayati MT
Ardalani S
Azizi S
Kalhori S
Kermani F
Mayahi S
author_facet Jalalian R
Shokohi T
Mirzakhani R
Ghasemian R
Hedayati MT
Ardalani S
Azizi S
Kalhori S
Kermani F
Mayahi S
author_sort Jalalian R
collection DOAJ
description Rozita Jalalian,1 Tahereh Shokohi,2,3 Roghayeh Mirzakhani,4 Roya Ghasemian,5 Mohammad Taghi Hedayati,2,3 Sirus Ardalani,6 Soheil Azizi,7 Shamsi Kalhori,7 Firoozeh Kermani,4 Sabah Mayahi3 1Department of Cardiology, Mazandaran University of Medical Sciences, Sari, Iran; 2Invasive Fungi Research Centre (IFRC), Mazandaran University of Medical Sciences, Sari, Iran; 3Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; 4Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; 5Antimicrobial Resistance Research Center, and Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran; 6Department of Cardiac Surgery, Cardiovascular Research Center of Mazandaran Heart Center, Mazandaran University of Medical Sciences, Sari, Iran; 7Department of Pathology, Mazandaran Heart Center, Mazandaran University of Medical Sciences, Sari, IranCorrespondence: Tahereh ShokohiDepartment of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, IranTel +98 11 3354-3087Fax +98 11 3354-3248Email Shokohi.tahereh@gmail.comAbstract: Aspergillus endocarditis (AE) accounts for a-quarter of all fungal endocarditis, mainly in immunocompromised hosts prior to heart-valve surgery with high mortality, even with treatment. Herein, we report a rare case of AE in a diabetic 60-year-old woman with a history of redo mitral valve prosthesis suspecious of acute endocarditis. She underwent second redo surgical mitral valve replacement in combination with mechanical aortic valve replacement. Blood cultures were negative. The explanted valve and vegetation were subjected to identification. Grown colonies were identified as Aspergillus flavus, based on conventional and molecular methods. Despite the administration of liposomal amphotericin B and improvement in her general condition shortly after initiation of therapy, the patient passed away. As AE is a late consequence of redo prosthetic valve replacement, extended follow-up, early diagnosis, repeating valve-replacement surgeries, and timely selective antifungal treatments are warranted.Keywords: fungal endocarditis, Aspergillus, antifungal, prosthetic valve replacement
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spelling doaj.art-4372dfb36fdf4e37830de5787b5a1fae2022-12-21T21:47:11ZengDove Medical PressInfection and Drug Resistance1178-69732020-07-01Volume 132245225055225Fatal Prosthetic Valve Endocarditis Due to Aspergillus flavus in a Diabetic PatientJalalian RShokohi TMirzakhani RGhasemian RHedayati MTArdalani SAzizi SKalhori SKermani FMayahi SRozita Jalalian,1 Tahereh Shokohi,2,3 Roghayeh Mirzakhani,4 Roya Ghasemian,5 Mohammad Taghi Hedayati,2,3 Sirus Ardalani,6 Soheil Azizi,7 Shamsi Kalhori,7 Firoozeh Kermani,4 Sabah Mayahi3 1Department of Cardiology, Mazandaran University of Medical Sciences, Sari, Iran; 2Invasive Fungi Research Centre (IFRC), Mazandaran University of Medical Sciences, Sari, Iran; 3Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; 4Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; 5Antimicrobial Resistance Research Center, and Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran; 6Department of Cardiac Surgery, Cardiovascular Research Center of Mazandaran Heart Center, Mazandaran University of Medical Sciences, Sari, Iran; 7Department of Pathology, Mazandaran Heart Center, Mazandaran University of Medical Sciences, Sari, IranCorrespondence: Tahereh ShokohiDepartment of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, IranTel +98 11 3354-3087Fax +98 11 3354-3248Email Shokohi.tahereh@gmail.comAbstract: Aspergillus endocarditis (AE) accounts for a-quarter of all fungal endocarditis, mainly in immunocompromised hosts prior to heart-valve surgery with high mortality, even with treatment. Herein, we report a rare case of AE in a diabetic 60-year-old woman with a history of redo mitral valve prosthesis suspecious of acute endocarditis. She underwent second redo surgical mitral valve replacement in combination with mechanical aortic valve replacement. Blood cultures were negative. The explanted valve and vegetation were subjected to identification. Grown colonies were identified as Aspergillus flavus, based on conventional and molecular methods. Despite the administration of liposomal amphotericin B and improvement in her general condition shortly after initiation of therapy, the patient passed away. As AE is a late consequence of redo prosthetic valve replacement, extended follow-up, early diagnosis, repeating valve-replacement surgeries, and timely selective antifungal treatments are warranted.Keywords: fungal endocarditis, Aspergillus, antifungal, prosthetic valve replacementhttps://www.dovepress.com/fatal-prosthetic-valve-endocarditis-due-to-aspergillus-flavus-in-a-dia-peer-reviewed-article-IDRfungal endocarditisaspergillusantifungalprosthetic valve replacement
spellingShingle Jalalian R
Shokohi T
Mirzakhani R
Ghasemian R
Hedayati MT
Ardalani S
Azizi S
Kalhori S
Kermani F
Mayahi S
Fatal Prosthetic Valve Endocarditis Due to Aspergillus flavus in a Diabetic Patient
Infection and Drug Resistance
fungal endocarditis
aspergillus
antifungal
prosthetic valve replacement
title Fatal Prosthetic Valve Endocarditis Due to Aspergillus flavus in a Diabetic Patient
title_full Fatal Prosthetic Valve Endocarditis Due to Aspergillus flavus in a Diabetic Patient
title_fullStr Fatal Prosthetic Valve Endocarditis Due to Aspergillus flavus in a Diabetic Patient
title_full_unstemmed Fatal Prosthetic Valve Endocarditis Due to Aspergillus flavus in a Diabetic Patient
title_short Fatal Prosthetic Valve Endocarditis Due to Aspergillus flavus in a Diabetic Patient
title_sort fatal prosthetic valve endocarditis due to aspergillus flavus in a diabetic patient
topic fungal endocarditis
aspergillus
antifungal
prosthetic valve replacement
url https://www.dovepress.com/fatal-prosthetic-valve-endocarditis-due-to-aspergillus-flavus-in-a-dia-peer-reviewed-article-IDR
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