title: Aspergillus pacemaker endocarditis presenting as pulmonary embolism.
abstract: Pacemaker endocarditis (PME) is a rare but severe complication of endocardial pacemaker implantation. Fungal PME is extremely uncommon. The case of a 66-year-old female patient who was diagnosed as having a pulmonary embolus based upon the patient's clinical presentation and computed tomography angiography findings is presented. Transthoracic echocardiography demonstrated a huge vegetation attached to the pacemaker wire. The pacemaker system was removed surgically during cardiovascular bypass. The vegetation was cultured, the results of which were positive for Aspergillus spp. No risk factors for Aspergillus infection were found in the patient. She was treated with liposomal amphotericin B for 3 weeks, followed by itraconazole for 40 weeks. At 1 year later, the patient remains asymptomatic.
authors.affiliation: Respiratory Section (Internal Medicine Service), Hospital de Monforte de Lemos, Lugo, Spain. alfonsomateos10@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Mateos-Colino
authors.forename: R
authors.initials: R
authors.lastname: Golpe
authors.forename: A
authors.initials: A
authors.lastname: González-Rodríguez
authors.forename: C
authors.initials: C
authors.lastname: González-Juanatey
authors.forename: J J
authors.initials: JJ
authors.lastname: Legarra
authors.forename: M
authors.initials: M
authors.lastname: Blanco
mesh_terms: D000368:Aged; D001228:Aspergillosis / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D001230:Aspergillus / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects* / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed