Neonatal aspergillus endocarditis: case report and review of literature

Neonatal fungal endocarditis (FE) remains a rare condition associated with prematurity. It often puts us in diagnostic and therapeutic dilemma as there are no specific guidelines. We described our successful journey with a 26 days old neonate with aspergillus endocarditis responding to multidisciplinary approach with surgical resection and intravenous antifungals.

Native versus Prosthetic Valve Histoplasma capsulatum Infective Endocarditis: A Case Report and Systemic Literature Review Comparing Patient Presentation, Treatment Modalities, Clinical Outcomes, and Diagnostic Laboratory Testing

Histoplasma capsulatum is a rare cause of fungal endocarditis that affects both native and prosthetic valves. It is associated with a high mortality rate if not diagnosed early and treated with a combination of antifungal therapy and surgical intervention. We present a case of a 47-year-old man with histoplasmosis infective endocarditis. He was successfully treated with antifungal therapy and surgical replacement of the infected bioprosthetic aortic valve. Our systemic literature review includes fifty-two articles encompassing sixty individual cases of H. capsulatum infective endocarditis from 1940 to 2020. Patient presentations, diagnostic laboratory testing accuracy, treatment modalities and patient outcomes, comparing and contrasting native and prosthetic valve infection, are described.

All that attaches to atrial septum is not myxoma: deception is everywhere!

Preterm neonates – especially those with prolonged duration of intensive care stay – are prone to develop fungal endocarditis. Majority of these children have a stormy course, however, a few may be relatively asymptomatic. Occasionally these vegetations may be large and pedunculated, originating from the atrial septum, mimicking a cardiac myxoma on echocardiography.

Fungal Endocarditis in a Preterm Neonate

Invasive fungal infections (IFIs) are an important cause of neonatal mortality and morbidity. A total of 5% of IFIs are complicated by fungal endocarditis. Mortality can be as high as 50%. We present a preterm, very low birth weight infant with infective endocarditis. Echocardiography showed a large pedunculated vegetation attached to the inferior vena cava and right atrium junction. Baby had Candida tropicalis in his blood cultures and was managed conservatively with antifungals. Surgery although planned was not possible considering baby being preterm with very low birth weight.

Aspergillus flavus endocarditis and meningitis in a child with marfan syndrome

Background and Purpose: Aspergillus species are implicated as the etiology of approximately 26% of endocarditis cases. Central nervous system aspergillosis is a life-threatening condition that has a mortality rate of 80%. Case report: Herein, we report a four– year- old female who was admitted to the pediatric infectious ward due to a fever of unknown origin in January 2020. She was a known case of Marfan syndrome with a family history of this syndrome in her mother. The species was identified using (PCR) and the antifungal susceptibility test was performed using four antifungal agents based on the Clinical and Laboratory Standards Institute M38 3rd edition. Fluconazole-resistant Aspergillus flavus was identified to be responsible for endocarditis and meningitis as well as fever of unknown origin. Conclusion: The clinicians should be aware and consider fungal endocarditis in blood culture-negative endocarditis even in patients with no significant risk factor when antibiotic therapy fails.