Successful treatment of Aspergillus mural endocarditis in malignant lymphoma using a combined antifungal and surgical approach: a case report
Abstract Background Aspergillus endocarditis (AE) is a rare and lethal cardiac infection with a high rate of mortality. AE most commonly presents in immunocompromised patients and is associated with various co-morbidities. Herein, we present a case of AE associated with lung, brain, and cervical abs...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2020-06-01
|
| Series: | Surgical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40792-020-00883-0 |
| _version_ | 1818026799068610560 |
|---|---|
| author | Yuya Hiroshima Soki Kurumisawa Kei Aizawa Noriyoshi Fukushima Koji Kawahito |
| author_facet | Yuya Hiroshima Soki Kurumisawa Kei Aizawa Noriyoshi Fukushima Koji Kawahito |
| author_sort | Yuya Hiroshima |
| collection | DOAJ |
| description | Abstract Background Aspergillus endocarditis (AE) is a rare and lethal cardiac infection with a high rate of mortality. AE most commonly presents in immunocompromised patients and is associated with various co-morbidities. Herein, we present a case of AE associated with lung, brain, and cervical abscesses after chemotherapy for malignant lymphoma that was successfully treated by a combination of antifungal and surgical therapy. Case presentation A 29-year-old man was admitted to our hospital with an unidentified fever. He was diagnosed with malignant lymphoma (extra-nodal NK/T cell lymphoma nasal type), and chemotherapy was administered. After chemotherapy, nodular lung shadows along with new brain, cervical, and myocardial abscesses appeared, despite anti-bacterial/fungal therapy. Gene analysis of the cervical abscess biopsy revealed the presence of Aspergillus fumigatus species, and the transesophageal echocardiogram showed a mobile mural vegetation in the left ventricle (22 × 8 mm). He underwent surgical resection of this mural vegetation. His postoperative course was uneventful. He remains healthy at 28 months after surgery with continued oral antifungal therapy. Conclusion Although AE associated with immunosuppression is a fatal clinical presentation, combined treatment with surgical resection and antifungal therapy was effective. |
| first_indexed | 2024-12-10T04:37:44Z |
| format | Article |
| id | doaj.art-b1f27a48f47342c3bff578faaa3043ad |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-12-10T04:37:44Z |
| publishDate | 2020-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-b1f27a48f47342c3bff578faaa3043ad2022-12-22T02:01:57ZengSpringerOpenSurgical Case Reports2198-77932020-06-01611610.1186/s40792-020-00883-0Successful treatment of Aspergillus mural endocarditis in malignant lymphoma using a combined antifungal and surgical approach: a case reportYuya Hiroshima0Soki Kurumisawa1Kei Aizawa2Noriyoshi Fukushima3Koji Kawahito4Department of Cardiovascular Surgery, Jichi Medical UniversityDepartment of Cardiovascular Surgery, Jichi Medical UniversityDepartment of Cardiovascular Surgery, Jichi Medical UniversityDepartment of Pathology, Jichi Medical UniversityDepartment of Cardiovascular Surgery, Jichi Medical UniversityAbstract Background Aspergillus endocarditis (AE) is a rare and lethal cardiac infection with a high rate of mortality. AE most commonly presents in immunocompromised patients and is associated with various co-morbidities. Herein, we present a case of AE associated with lung, brain, and cervical abscesses after chemotherapy for malignant lymphoma that was successfully treated by a combination of antifungal and surgical therapy. Case presentation A 29-year-old man was admitted to our hospital with an unidentified fever. He was diagnosed with malignant lymphoma (extra-nodal NK/T cell lymphoma nasal type), and chemotherapy was administered. After chemotherapy, nodular lung shadows along with new brain, cervical, and myocardial abscesses appeared, despite anti-bacterial/fungal therapy. Gene analysis of the cervical abscess biopsy revealed the presence of Aspergillus fumigatus species, and the transesophageal echocardiogram showed a mobile mural vegetation in the left ventricle (22 × 8 mm). He underwent surgical resection of this mural vegetation. His postoperative course was uneventful. He remains healthy at 28 months after surgery with continued oral antifungal therapy. Conclusion Although AE associated with immunosuppression is a fatal clinical presentation, combined treatment with surgical resection and antifungal therapy was effective.http://link.springer.com/article/10.1186/s40792-020-00883-0Aspergillus endocarditisFungal endocarditisMalignant lymphomaImmunosuppressionCase report |
| spellingShingle | Yuya Hiroshima Soki Kurumisawa Kei Aizawa Noriyoshi Fukushima Koji Kawahito Successful treatment of Aspergillus mural endocarditis in malignant lymphoma using a combined antifungal and surgical approach: a case report Surgical Case Reports Aspergillus endocarditis Fungal endocarditis Malignant lymphoma Immunosuppression Case report |
| title | Successful treatment of Aspergillus mural endocarditis in malignant lymphoma using a combined antifungal and surgical approach: a case report |
| title_full | Successful treatment of Aspergillus mural endocarditis in malignant lymphoma using a combined antifungal and surgical approach: a case report |
| title_fullStr | Successful treatment of Aspergillus mural endocarditis in malignant lymphoma using a combined antifungal and surgical approach: a case report |
| title_full_unstemmed | Successful treatment of Aspergillus mural endocarditis in malignant lymphoma using a combined antifungal and surgical approach: a case report |
| title_short | Successful treatment of Aspergillus mural endocarditis in malignant lymphoma using a combined antifungal and surgical approach: a case report |
| title_sort | successful treatment of aspergillus mural endocarditis in malignant lymphoma using a combined antifungal and surgical approach a case report |
| topic | Aspergillus endocarditis Fungal endocarditis Malignant lymphoma Immunosuppression Case report |
| url | http://link.springer.com/article/10.1186/s40792-020-00883-0 |
| work_keys_str_mv | AT yuyahiroshima successfultreatmentofaspergillusmuralendocarditisinmalignantlymphomausingacombinedantifungalandsurgicalapproachacasereport AT sokikurumisawa successfultreatmentofaspergillusmuralendocarditisinmalignantlymphomausingacombinedantifungalandsurgicalapproachacasereport AT keiaizawa successfultreatmentofaspergillusmuralendocarditisinmalignantlymphomausingacombinedantifungalandsurgicalapproachacasereport AT noriyoshifukushima successfultreatmentofaspergillusmuralendocarditisinmalignantlymphomausingacombinedantifungalandsurgicalapproachacasereport AT kojikawahito successfultreatmentofaspergillusmuralendocarditisinmalignantlymphomausingacombinedantifungalandsurgicalapproachacasereport |