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Ann Thorac Surg 2005;80:359-364
© 2005 The Society of Thoracic Surgeons

Review

Aspergillus Endocarditis After Cardiac Surgery

Ismaïl El-Hamamsy, MD, Nicolas Dürrleman, MD, Louis-Mathieu Stevens, MD, Louis P. Perrault, MD, PhD, Michel Carrier, MD*

Research Center and Department of Surgery, Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada

* Address reprint requests to Dr Carrier, Montreal Heart Institute, 5000 Belanger St E, Montreal, PQ H1T 1C8, Canada (Email: carrier{at}icm.umontreal.ca).

Aspergillus species infections are an increasingly common occurrence in hospital wards. Aspergillus endocarditis constitutes one of the manifestations of the disease, which bears a poor prognosis in cardiac surgery patients. A review of the literature on fungal and Aspergillus endocarditis was undertaken. Valvular risk factors, indwelling intravenous catheters, prolonged antibiotics, malignancy, and intravenous drug use increase the risk. Clinical presentation is insidious, with embolic complications often representing the first manifestation of the disease. Blood cultures are typically negative. The mortality rate is almost 100%. Amphotericin B represents the mainstay of medical therapy with several possible adjuncts. Surgery is an essential part of therapy in Aspergillus endocarditis after cardiac surgery and should be undertaken as soon as the diagnosis is made. Aspergillus endocarditis is an ominous complication after cardiac surgery. A high suspicion index, early administration of appropriate antibiotics, and prompt surgical intervention should improve the prognosis, which remains dismal.




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M. Esmaeilzadeh, M. Parsaee, M. M. Peighambari, A. Sadeghpour, A. J. Khamooshi, S. S. Hosseini, and K. Mozaffari
Late occurrence of fatal aortitis: a complication of Aspergillus endocarditis following coronary artery bypass graft surgery
Eur J Echocardiogr, January 1, 2009; 10(1): 165 - 167.
[Abstract] [Full Text] [PDF]


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