Aspergillus flavus endocarditis in an immunocompetent child. Case report

Abstract

Fungal endocarditis (FE) is a rare infection in pediatrics which accounts for 5% of the cases of infective endocarditis. This pathology affects immunosuppressed patients in a greater proportion. We present an immunocompetent 7- year-old female with a history of multiple cardiac surgeries who developed fungal endocarditis due to Aspergillus flavus. The histology study showed liquefactive necrosis and septate hyphae of Aspergillus sp type. The clinical outcome was favorable and the ambulatory follow-up after 12 months showed no new complications.

Keywords: Aspergillus; Immunocompetence; Ndocarditis; Outcomes.

Fig. 1

(A). Pulmonary valve with little mobility with a 3 × 1.5 cm thrombus that almost completely obstructs pulmonary blood flow, with dilatation and severe right ventricular dysfunction and tricuspid regurgitation. (B). Mobile thrombus (vegetation) of 30 × 10 mm at the homograft lung level on the right posterior leaflet and one of 12 × 10 mm on the left posterior leaflet.

Fig. 2

(A). Coronal section, (B). Axial section: Pulmonary valve dilatation surgically manipulated with hypodense vegetations of valvular walls (axial section). In addition, a dilated aspect of the main pulmonary artery with a diameter greater than 25 mm and the right pulmonary artery with a diameter greater than 22 mm. There is also a large defect in right pulmonary artery filling in the saddle, a thrombus that extends to its segmentation and is accompanied by a right hilar alveolar opacity. (C). PAS staining: Severed hyphae of Aspergillus sp type are observed on the pulmonary homograft.