A renal transplant recipient with a pulmonic valve mass

Ilyse Darwish; Benoît de Varennes; Pierre Olivier Fiset; Sophie Camilleri-Broët; Vynka Lash; Marcelo Cantarovich; Todd C Lee; Cecilia T Costiniuk

doi:10.1016/j.carpath.2025.107745

A renal transplant recipient with a pulmonic valve mass

Cardiovasc Pathol. 2025 Jun 13:78:107745. doi: 10.1016/j.carpath.2025.107745. Online ahead of print.

Authors

Ilyse Darwish¹, Benoît de Varennes², Pierre Olivier Fiset³, Sophie Camilleri-Broët³, Vynka Lash⁴, Marcelo Cantarovich⁵, Todd C Lee⁶, Cecilia T Costiniuk⁷

Affiliations

¹ Department of Medicine, Division of Infectious Diseases, St. Mary's Hospital, Montréal, Quebec, Canada.
² Department of Surgery, McGill University Health Centre, Montréal, Quebec, Canada.
³ Department of Pathology, McGill University Health Centre, Montréal, Quebec, Canada.
⁴ Department of Anaesthesia, McGill University Health Centre, Montréal, Quebec, Canada.
⁵ Department of Medicine, Division of Nephrology, McGill University Health Centre, Montréal, Quebec, Canada.
⁶ Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Quebec, Canada; Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, Montréal, Quebec, Canada.
⁷ Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Quebec, Canada; Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, Montréal, Quebec, Canada. Electronic address: cecilia.costiniuk@mcgill.ca.

PMID: 40518127
DOI: 10.1016/j.carpath.2025.107745

Abstract

A 43-year-old female with a renal transplant presented with fatigue, dyspnea, anemia, and thrombocytopenia. Chest CT revealed pulmonary nodules, and transthoracic echocardiography identified a large, multi-lobulated, multi-cystic mass attached to the pulmonic valve. Pathology demonstrated fungal hyphae, and bronchoalveolar lavage (BAL) fluid grew Aspergillus fumigatus, with a serum Aspergillus galactomannan (GM) antigen index of 1.95. The pulmonic valve was excised and a bioprosthetic valve was inserted. The patient was treated with voriconazole. Pulmonic valve Aspergillus endocarditis (AE) is a rare condition associated with high mortality. Given the rising number of transplant recipients, heightened clinical vigilance is warranted in this population.

Keywords: Aspergillosis; Blood culture-negative endocarditis; Infective endocarditis; Invasive Aspergillosis; Pulmonic valve endocarditis.

Publication types

Case Reports