Aspergillus endocarditis 2003-2009

McCormack, Joe and Pollard, James (2011). Aspergillus endocarditis 2003-2009. In: Brahm H. Segal, Oliver Cornely and MichaelL Bromley, Proceedings from the 4th Advances Against Aspergillosis Conference. 4th Advances Against Aspergillosis (AAA) Conference, Rome, Italy, (S30-S34). 4-6 January, 2010. doi:10.3109/13693786.2010.498449

Author McCormack, Joe
Pollard, James
Title of paper Aspergillus endocarditis 2003-2009
Formatted title
Aspergillus endocarditis 2003-2009
Conference name 4th Advances Against Aspergillosis (AAA) Conference
Conference location Rome, Italy
Conference dates 4-6 January, 2010
Proceedings title Proceedings from the 4th Advances Against Aspergillosis Conference   Check publisher's open access policy
Journal name Medical Mycology   Check publisher's open access policy
Place of Publication United Kingdom
Publisher Informa Healthcare
Publication Year 2011
Year available 2010
Sub-type Fully published paper
DOI 10.3109/13693786.2010.498449
ISSN 1369-3786
Editor Brahm H. Segal
Oliver Cornely
MichaelL Bromley
Volume 49
Issue Supp.1
Start page S30
End page S34
Total pages 5
Collection year 2012
Language eng
Abstract/Summary A retrospective study of 35 case reports of Aspergillus endocarditis published between 2003 and 2009 was carried out. Fifteen percent of cases presented with a new cardiac murmur, 38% with an embolus. Eighty percent of cases involved the aortic or mitral valves. Seventy-four percent of cases involved patients with a history of prior surgery, 48% of these involved a heart valve, 20% had other cardiac surgery and 32% had non-cardiac surgery. Galactomannan testing was helpful diagnostically in four out of nine cases, but PCR testing was positive in six out of six cases. Overall mortality was 68%, all eight survivors had heart valve surgery apart from one – an 8-month-old child. Seven out of eight survivors received liposomal amphotericin B, three of these in combination with other antifungals. We need to think more about the possibility of Aspergillus endocarditis, particularly in immunocompromised patients with recent surgery. Galactomannan and PCR testing may be used more vigorously. Valve replacement, or at least vegetectomy, should be carried out in all patients. Liposomal amphotericin B, 3–5mg/kg/day, for at least 4 weeks is the treatment of choice. Oral voriconazole should be used for at least 2 years. Posaconazole may be an alternative, however there have been no prior cases reported to suggest its efficacy. The value of combination antifungal therapy is uncertain, but consideration should be given to the use of a second agent in addition to liposomal amphotericin. While further case reports on this condition will be helpful, more definitive management guidelines will depend on a prospective study.
Subjects 060505 Mycology
Keyword Aspergillus
Antifungal therapy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes This paper was first published on Early online on 7 July 2010.

Document type: Conference Paper
Collections: Official 2011 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 24 Mar 2011, 15:06:58 EST by Miss Kathryn Marquet on behalf of Medicine - Mater Hospital