JACC. Case reports · 2026
Recurrent Prosthetic Aortic Valve Aspergillus Endocarditis Requiring Fourth Redo Root Surgery.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kaufmann Krista, Calcagno Tess, Unai Shinya, Puri Rishi, Caputo Francis J, Fraser Thomas, El Roumi Joseph, Misra Anisha, Tan Carmela, Ruthmann Nicholas
Аннотация
BACKGROUND: Fungal prosthetic valve endocarditis is rare, frequently culture-negative, and often complicated by embolization, making diagnosis challenging.
CASE SUMMARY: A 58-year-old man with prior bioprosthetic aortic valve surgery presented with splenic infarction and prosthetic valve dysfunction. Transesophageal echocardiography demonstrated an immobile echodensity encasing the valve, with elevated gradients. Blood cultures and serologic testing were repeatedly negative, and he was initially treated for presumed valve thrombosis. Despite therapeutic anticoagulation, he developed recurrent fevers and popliteal artery emboli, prompting urgent surgery. Operative findings revealed friable vegetations and a shallow aortic root abscess. Histopathology demonstrated fungal elements, and MALDI-TOF mass spectrometry identified a cryptic species within the Aspergillus fumigatus section, Aspergillus (Neosartorya) hiratsukae, with sexual reproductive structures.
DISCUSSION: The case highlights the limitations of conventional diagnostics and the value of advanced microbiologic identification.
TAKE-HOME MESSAGE: Culture-negative prosthetic valve dysfunction with embolization should prompt suspicion for fungal endocarditis and early surgical consideration.
CASE SUMMARY: A 58-year-old man with prior bioprosthetic aortic valve surgery presented with splenic infarction and prosthetic valve dysfunction. Transesophageal echocardiography demonstrated an immobile echodensity encasing the valve, with elevated gradients. Blood cultures and serologic testing were repeatedly negative, and he was initially treated for presumed valve thrombosis. Despite therapeutic anticoagulation, he developed recurrent fevers and popliteal artery emboli, prompting urgent surgery. Operative findings revealed friable vegetations and a shallow aortic root abscess. Histopathology demonstrated fungal elements, and MALDI-TOF mass spectrometry identified a cryptic species within the Aspergillus fumigatus section, Aspergillus (Neosartorya) hiratsukae, with sexual reproductive structures.
DISCUSSION: The case highlights the limitations of conventional diagnostics and the value of advanced microbiologic identification.
TAKE-HOME MESSAGE: Culture-negative prosthetic valve dysfunction with embolization should prompt suspicion for fungal endocarditis and early surgical consideration.