| Autor: |
Delos M. Cosgrove, Alan J. Taege, Steven M. Gordon, Martin C. McHenry, Steven D. Mawhorter, Tawanda Gumbo, Bruce H. Lytle |
| Rok vydání: |
2000 |
| Předmět: |
|
| Zdroj: |
Medicine. 79:261-268 |
| ISSN: |
0025-7974 |
| DOI: |
10.1097/00005792-200007000-00007 |
| Popis: |
Aspergillus native valve endocarditis in patients who have not had cardiac surgery is uncommon. We report 3 cases and review 58 other adult patients reported in the English-language literature. Sixty-seven percent of the patients had underlying immunosuppression. The clinical features were fever (74%), embolic episodes (69%), a new or changing heart murmur (41%), and sudden visual loss (13%). Patients with mural endocarditis were more often immunosuppressed, especially due to solid organ transplants, but had lower frequency of heart murmurs and embolic episodes. Echocardiography revealed a vegetation in 78% of all the cases in which it was performed. Examination and culture of biopsy material often helped to establish a diagnosis of Aspergillus infection. Twenty-five patients had an antemortem diagnosis. These patients received a mean cumulative amphotericin B dose of 27 mg/kg. Twenty percent (3/15) of patients who received combined surgical and medical therapy survived, compared to none of those who received medical therapy alone (p = 0.08). Patients who survived were not immunosuppressed. We conclude that native valve aspergillus infective endocarditis is uniformly fatal without surgical intervention and antifungal therapy. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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