PDF(Pubmed)
Abstract：
BACKGROUND: Aspergillus spp. are among the fungal pathogens that can cause life-threatening infections in patients with a history of COVID-19.
METHODS: We present the case of a 58-year-old Iranian woman with post-COVID-19 Aspergillus fumigatus endocarditis complicated by numerous thromboembolisms. She underwent mitral valve replacement surgery and multiple lower extremity embolectomies and was treated with voriconazole, which led to her final recovery.
CONCLUSIONS: Aspergillus endocarditis should be considered in any patient with suspected endocarditis who has a history of COVID-19 infection and does not respond to routine antibiotic and antifungal therapy, as COVID-19 interferes with proper immune function, and lack of underlying cardiac conditions and immunodeficiencies does not preclude the diagnosis. Culture and histopathological evaluation of vegetations and emboli, as well as PCR, can confirm the diagnosis. Early initiation of antifungal therapy and surgical removal of infected valves and emboli can improve prognosis in patients with Aspergillus endocarditis.
METHODS: We present the case of a 58-year-old Iranian woman with post-COVID-19 Aspergillus fumigatus endocarditis complicated by numerous thromboembolisms. She underwent mitral valve replacement surgery and multiple lower extremity embolectomies and was treated with voriconazole, which led to her final recovery.
CONCLUSIONS: Aspergillus endocarditis should be considered in any patient with suspected endocarditis who has a history of COVID-19 infection and does not respond to routine antibiotic and antifungal therapy, as COVID-19 interferes with proper immune function, and lack of underlying cardiac conditions and immunodeficiencies does not preclude the diagnosis. Culture and histopathological evaluation of vegetations and emboli, as well as PCR, can confirm the diagnosis. Early initiation of antifungal therapy and surgical removal of infected valves and emboli can improve prognosis in patients with Aspergillus endocarditis.
摘要：
背景：曲霉属。在有COVID-19病史的患者中，是可能导致危及生命的感染的真菌病原体之一。
方法：我们介绍了一名58岁的伊朗妇女患有COVID-19感染后烟曲霉心内膜炎并伴有多种血栓栓塞的病例。她接受了二尖瓣置换手术和多次下肢栓塞切除术，并接受了伏立康唑治疗，最终导致了她的康复.
结论：任何有COVID-19感染史且对常规抗生素和抗真菌治疗无反应的疑似心内膜炎患者，应考虑曲霉菌性心内膜炎，因为COVID-19干扰适当的免疫功能，缺乏潜在的心脏疾病和免疫缺陷并不排除诊断。植被和栓子的培养和组织病理学评估，以及PCR，可以确认诊断。早期开始抗真菌治疗和手术切除感染的瓣膜和栓子可以改善曲霉菌性心内膜炎患者的预后。
方法：我们介绍了一名58岁的伊朗妇女患有COVID-19感染后烟曲霉心内膜炎并伴有多种血栓栓塞的病例。她接受了二尖瓣置换手术和多次下肢栓塞切除术，并接受了伏立康唑治疗，最终导致了她的康复.
结论：任何有COVID-19感染史且对常规抗生素和抗真菌治疗无反应的疑似心内膜炎患者，应考虑曲霉菌性心内膜炎，因为COVID-19干扰适当的免疫功能，缺乏潜在的心脏疾病和免疫缺陷并不排除诊断。植被和栓子的培养和组织病理学评估，以及PCR，可以确认诊断。早期开始抗真菌治疗和手术切除感染的瓣膜和栓子可以改善曲霉菌性心内膜炎患者的预后。
