Aspergillus Flavus Endocarditis of the Native Mitral Valve in a Bone Marrow Transplant Patient

Background: Infective endocarditis due to Aspergillus species is an uncommon infection with a high mortality rate. It mostly occurs after the implantation of prosthetic heart valves. Parenteral nutrition, immunosuppression, broad-spectrum antibiotic regimens, and illegal intravenous drug use are the risk factors for developing infection.
Case Report: We report a case of Aspergillus flavus native mitral valve endocarditis in a patient who had allogeneic stem cell transplantation in the past due to myelodysplastic syndrome.

Conclusions: Although it is rare and there is limited experience available with the diagnosis and treatment, early recognition and therapeutic intervention with systemic antifungal therapy and aggressive surgical intervention are critical to prevent further complications that may eventually lead to death. In addition, better novel diagnostic tools are needed to facilitate more accurate identification of patients with invasive Aspergillus and to permit earlier initiation of antifungal treatment.

Keywords: Antifungal Agents - therapeutic use, Adult, Aspergillus flavus - isolation & purification, Bone Marrow Transplantation - adverse effects, Endocarditis, Bacterial - etiology, Heart Valve Prosthesis - microbiology, Mitral Valve - surgery, Myelodysplastic Syndromes - surgery, Tomography, X-Ray Computed