title: Polymerase chain reaction aids in the diagnosis of an unusual case of Aspergillus niger endocarditis in a patient with acute myeloid leukaemia.
abstract: Endocarditis secondary to Aspergillus niger has not been described in a leukaemic patient. We describe a case of A. niger endocarditis in a patient with acute myeloid leukaemia and refractory fever. The microbiological cause of his endocarditis was initially misdiagnosed because he fulfilled the Duke criteria for enterococcal endocarditis. A polymerase chain reaction test utilizing pan-fungal primers detected a product from an Aspergillus sp. The DNA was subsequently sequenced and was found to have 100% homology with A. niger. A postmortem revealed fungal endocarditis secondary to disseminated aspergillosis, without evidence of bacterial endocarditis. The patient was found to have a lung aspergilloma that was possibly occupationally acquired, and may have been long standing.
authors.affiliation: Department of Medical Microbiology and NPHS, University Hospital of Wales, Cardiff, UK. diane.mccracken@nphs.wales.nhs.uk
authors.forename: D
authors.initials: D
authors.lastname: McCracken
authors.forename: R
authors.initials: R
authors.lastname: Barnes
authors.forename: C
authors.initials: C
authors.lastname: Poynton
authors.forename: P L
authors.initials: PL
authors.lastname: White
authors.forename: N
authors.initials: N
authors.lastname: Işik
authors.forename: D
authors.initials: D
authors.lastname: Cook
mesh_terms: D001228:Aspergillosis / Q000175:diagnosis* / Q000382:microbiology; D001234:Aspergillus niger / Q000302:isolation & purification*; D004271:DNA, Fungal / Q000032:analysis; D004696:Endocarditis / Q000175:diagnosis* / Q000382:microbiology*; D017809:Fatal Outcome; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*
chemical_list: D004271:DNA, Fungal