Aspergillus infection in the ascending aorta of a patient with aortic and mitral valve prostheses.
We report the case of implantation of metallic mitral and aortic valve prostheses 6 months earlier, with subsequent multiple embolic episodes. The anatomicopathological examination of the thrombus of the third embolic episode was compatible with Aspergillus sp, which was treated with amphotericin B, followed by oral itraconazole. On the fourth embolism, vegetations were visualized in the ascending aorta on echocardiography and resonance imaging, and the patient underwent replacement of the aortic segment by a Haemashield tube and exploration of the aortic prosthesis, which was preserved, because no signs of endocarditis were found. Four months later, the patient died due to cardiogenic shock secondary to acute myocardial infarction caused by probable coronary embolism and partial dysfunction of the aortic prosthesis.
Ramos
Auristela de Oliveira
Ade O
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil. rafframos@uol.com.br
Medeiros
Amira Rose Costa
AR
Paulista
Paulo Paredes
PP
Abboud
Cely Saad
CS
Meneghelo
Zilda Machado
ZM
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001011:Aorta / Q000382:microbiology*; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D006350:Heart Valve Prosthesis / Q000382:microbiology*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*
D000935:Antifungal Agents