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KMID : 0882420080750010115
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Korean Journal of Medicine
2008 Volume.75 No. 1 p.115 ~ p.118
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A case of infective endocarditis caused by Aspergillus fumigatus in a liver transplant recipient
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Hong Kyung-Wook
Lee Jeong-A
Park Hye-Won
Kwon Hye-Lee
Cho Seong-Jin
Kim Jae-Seok
Eom Joong-Sik
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Abstract
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It is known that the incidence of fungal endocarditis is increasing as the precipitating factors, such as organ transplantation, use of immunosuppressive agents, previous cardiac surgery, AIDS, chemotherapy, and long-term antibiotic use are on the rise. However, the diagnosis and adequate treatment of fungal endocarditis is likely to be delayed as blood cultures are rarely positive.
We report a case of native valve endocarditis in a patient who underwent liver transplantation and was taking immunosuppressive agents. Because of no improvement despite empirical antibiotic treatment, a mitral valve replacement was performed. Tissue culture and biopsy of the vegetations revealed Aspergillus spp., and A. fumigatus was identified by analysis of internal transcribed spacer DNA sequences of the pathogenic fungus using a polymerase chain reaction. Despite surgical intervention, she died of an acute cerebral infarction with cerebral edema.
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KEYWORD
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Aspergillus fumigatus, Endocarditis, Liver transplantation
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