Fungal prosthetic aortic valve endocarditis and endarteritis: An unusual cause of aortic root vegetations

Echocardiography. 2019 Feb;36(2):401-405. doi: 10.1111/echo.14233. Epub 2018 Dec 28.

Abstract

Fungal endocarditis is a relatively rare occurrence with high morbidity and mortality. Patients may have an indolent and non-specific course requiring a high index of suspicion to make a diagnosis. Here, we present the case of a 33-year-old patient who presented with fevers and acute lower limb ischemia requiring a 4-compartment fasciotomy caused by septic emboli from Candida albicans endocarditis. The patient had a large vegetation in the ascending aorta associated with a mycotic aneurysm, which is an exceedingly rare location for a vegetation. We also review the literature and summarize the typical echocardiographic appearance and vegetation locations in fungal endocarditis.

Keywords: Candida; aorta; echocardiogram; endocarditis; nonvalvular.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm, Infected / complications*
  • Aneurysm, Infected / diagnostic imaging
  • Aneurysm, Infected / therapy
  • Antifungal Agents / therapeutic use
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / microbiology
  • Aortic Valve / surgery
  • Candida albicans
  • Candidiasis / complications*
  • Candidiasis / diagnostic imaging
  • Candidiasis / therapy
  • Diagnosis, Differential
  • Echocardiography
  • Endarteritis / complications*
  • Endarteritis / diagnostic imaging
  • Endarteritis / therapy
  • Heart Valve Diseases / complications*
  • Heart Valve Diseases / diagnostic imaging
  • Heart Valve Diseases / therapy
  • Heart Valve Prosthesis / microbiology
  • Humans
  • Male
  • Micafungin / therapeutic use
  • Prosthesis-Related Infections / complications*
  • Prosthesis-Related Infections / diagnostic imaging
  • Prosthesis-Related Infections / therapy

Substances

  • Antifungal Agents
  • Micafungin