Aspergillus tubingensis Endocarditis: A Case Report and Review of the Literature
| Autor: | Tristan Born, Marion Aruanno, Eleftheria Kampouri, Matteo Mombelli, Pierre Monney, Piergiorgio Tozzi, Frederic Lamoth |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Antifungal Agents Endocarditis Veterinary (miscellaneous) Microbial Sensitivity Tests Amphotericin B/pharmacology Amphotericin B/therapeutic use Antifungal Agents/pharmacology Antifungal Agents/therapeutic use Aspergillosis/diagnosis Aspergillosis/drug therapy Aspergillosis/microbiology Aspergillus Echinocandins/pharmacology Echinocandins/therapeutic use Endocarditis/diagnosis Endocarditis/drug therapy Female Humans Voriconazole/pharmacology Voriconazole/therapeutic use Aortitis Aspergillus niger Fungal biofilm Invasive aspergillosis Section Nigri Applied Microbiology and Biotechnology Microbiology Echinocandins Amphotericin B Aspergillosis Voriconazole Agronomy and Crop Science |
| Zdroj: | Mycopathologia, vol. 187, no. 2-3, pp. 249-258 |
| ISSN: | 1573-0832 0301-486X |
| Popis: | Aspergillus endocarditis is a rare infection that may affect immunocompetent patients following heart valve replacement or heart surgery. We report the case of a 39 year old woman with a history of intravenous drug use who developed endocarditis with direct examination of the resected valve and vegetation showing the presence of mycelia. Cultures were positive for an Aspergillus of section Nigri, which was subsequently identified as Aspergillus tubingensis by sequencing. The clinical course was favorable following surgery and prolonged antifungal therapy (8 months in total). Antifungal susceptibility testing showed good in vitro activity of amphotericin B, voriconazole and echinocandins against planktonic cells of this A. tubingensis isolate. However, only amphotericin B displayed significant activity against biofilms. In vitro combinations of voriconazole or amphotericin B with echinocandins did not meet the criteria of synergism. Our review of the literature identified 17 other cases of endocarditis attributed to Aspergillus of section Nigri with an overall mortality rate of 57% (100% in the absence of surgery). Endocarditis caused by Aspergillus niger and related cryptic species are rare events, for which surgical management appears to be crucial for outcome. While amphotericin B was the only antifungal drug displaying significant anti-biofilm activity, the type and duration of antifungal therapy remain to be determined. |
| Databáze: | OpenAIRE |
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