Al-Mashdali Abdulrahman F, Alamin Mohammed A, Kanaan Ammar M, Alkhulaifi Abdulaziz, Al Kindi Dawoud I
Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
IDCases. 2021 Oct 13;26:e01310. doi: 10.1016/j.idcr.2021.e01310. eCollection 2021.
Fungal endocarditis is a rare condition, specifically in immunocompetent patients. Aspergillus species are the etiology in less than 30% of the cases. Moreover, endocarditis is extremely rare and reported in only 7% of the total Aspergillus endocarditis cases. The most common predisposing factors are immunocompromised state, prosthetic valve, and previous cardiac surgery. In most cases, the diagnosis is delayed and occasionally missed. Prompt medical management combined with early surgical intervention is recommended once the diagnosis is established since the mortality rate is nearly 100% without surgical intervention. We report a rare and fatal case of native aortic valve endocarditis in a 49 years old diabetic patient who presented with fever and abdominal pain, complicated by multiple septic embolizations (splenic infarction, cerebral emboli, and limbs ischemia), and in which A. was confirmed post mortem.
真菌性心内膜炎是一种罕见病症,在免疫功能正常的患者中尤为少见。曲霉属是不到30%病例的病因。此外,心内膜炎极为罕见,仅占曲霉性心内膜炎病例总数的7%。最常见的易感因素是免疫功能低下状态、人工瓣膜和既往心脏手术。在大多数情况下,诊断会延迟,偶尔还会漏诊。一旦确诊,建议立即进行药物治疗并尽早进行手术干预,因为未经手术干预的死亡率接近100%。我们报告一例罕见的致命性原发性主动脉瓣心内膜炎病例,患者为一名49岁的糖尿病患者,表现为发热和腹痛,并发多处脓毒性栓塞(脾梗死、脑栓塞和肢体缺血),尸检确诊为曲霉感染。