Aspergillus endocarditis diagnosed by fungemia plus serum antigen testing

Hatlen, Timothy; Filler, Scott G.; Bayer, Arnold S.; Shah, Sonia; Shodhan, Shivani; Van, Tam T.

doi:10.1016/j.mmcr.2018.10.004

Cited by 9 publications

(12 citation statements)

References 18 publications

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“…A review article that included 20 cases of AE showed that Aspergillus PCR test was positive in all cases, while BDG and GM were positive in 85.7% and 62.5% of cases, respectively. However, all three tests were negative in 20% of the cases [7] , [8] , [9] .…”

Section: Discussionmentioning

confidence: 93%

Fatal native aortic valve fungal endocarditis caused by Aspergillus flavus: A case report

Al-Mashdali

Alamin

Kanaan

et al. 2021

IDCases

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Fungal endocarditis is a rare condition, specifically in immunocompetent patients. Aspergillus species are the etiology in less than 30% of the cases. Moreover, Aspergillus flavus endocarditis is extremely rare and reported in only 7% of the total Aspergillus endocarditis cases. The most common predisposing factors are immunocompromised state, prosthetic valve, and previous cardiac surgery. In most cases, the diagnosis is delayed and occasionally missed. Prompt medical management combined with early surgical intervention is recommended once the diagnosis is established since the mortality rate is nearly 100% without surgical intervention. We report a rare and fatal case of native aortic valve endocarditis in a 49 years old diabetic patient who presented with fever and abdominal pain, complicated by multiple septic embolizations (splenic infarction, cerebral emboli, and limbs ischemia), and in which A. flavus was confirmed post mortem.

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Section: Discussionmentioning

confidence: 93%

Fatal native aortic valve fungal endocarditis caused by Aspergillus flavus: A case report

Al-Mashdali

Alamin

Kanaan

et al. 2021

IDCases

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“…7 In cases of endocarditis with negative blood culture, for accurate and early diagnosis and ruling out fungal etiology, 1,3-β-D-glucans (BDG) and/or galactomannan (GM) are promising approaches for AE to initiate antifungal therapy prior to vulvar dysfunction, heart failure, and/or embolic phenomena. 18 As a cell-wall biomarker of Aspergillus, GM has been widely used to diagnose invasive aspergillosis in neutropenic patients. Since the GM antigen is cleared by neutrophils, its usage in non-neutropenic patients is limited, due to low diagnostic value and high likelihood of false-negative results.…”

Section: Discussionmentioning

confidence: 99%

<p>Fatal Prosthetic Valve Endocarditis Due to <em>Aspergillus flavus</em> in a Diabetic Patient</p>

Jalalian¹,

Shokohi²,

Mirzakhani³

et al. 2020

IDR

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Aspergillus endocarditis (AE) accounts for a-quarter of all fungal endocarditis, mainly in immunocompromised hosts prior to heart-valve surgery with high mortality, even with treatment. Herein, we report a rare case of AE in a diabetic 60-year-old woman with a history of redo mitral valve prosthesis suspecious of acute endocarditis. She underwent second redo surgical mitral valve replacement in combination with mechanical aortic valve replacement. Blood cultures were negative. The explanted valve and vegetation were subjected to identification. Grown colonies were identified as Aspergillus flavus, based on conventional and molecular methods. Despite the administration of liposomal amphotericin B and improvement in her general condition shortly after initiation of therapy, the patient passed away. As AE is a late consequence of redo prosthetic valve replacement, extended follow-up, early diagnosis, repeating valve-replacement surgeries, and timely selective antifungal treatments are warranted.

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“…Previous studies conducted by Erhlich [ 108 ] revealed that co-inoculation of AF − strains with AF + substantially reduced the production of AF in corn under in vitro conditions. The potential for biocontrol of AFs using AF − strains has been demonstrated under field conditions in cotton [ 109 ], peanuts [ 85 ], and corn [ 97 , 110 ]. These scientists have applied the AF − strain to the soil as infested grain cultures of barley, rice, or wheat, whereas [ 111 ] inoculated corn ears directly by injection.…”

Section: Efficacy Of Non-aflatoxigenic Strains As Biocontrol Agentsmentioning

confidence: 99%

Biocontrol of Aflatoxins Using Non-Aflatoxigenic Aspergillus flavus: A Literature Review

Khan

Ghazali

Mahyudin

et al. 2021

JoF

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Aflatoxins (AFs) are mycotoxins, predominantly produced by Aspergillus flavus, A. parasiticus, A. nomius, and A. pseudotamarii. AFs are carcinogenic compounds causing liver cancer in humans and animals. Physical and biological factors significantly affect AF production during the pre-and post-harvest time. Several methodologies have been developed to control AF contamination, yet; they are usually expensive and unfriendly to the environment. Consequently, interest in using biocontrol agents has increased, as they are convenient, advanced, and friendly to the environment. Using non-aflatoxigenic strains of A. flavus (AF−) as biocontrol agents is the most promising method to control AFs’ contamination in cereal crops. AF− strains cannot produce AFs due to the absence of polyketide synthase genes or genetic mutation. AF− strains competitively exclude the AF+ strains in the field, giving an extra advantage to the stored grains. Several microbiological, molecular, and field-based approaches have been used to select a suitable biocontrol agent. The effectiveness of biocontrol agents in controlling AF contamination could reach up to 99.3%. Optimal inoculum rate and a perfect time of application are critical factors influencing the efficacy of biocontrol agents.

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Aspergillus endocarditis diagnosed by fungemia plus serum antigen testing

Cited by 9 publications

References 18 publications

Fatal native aortic valve fungal endocarditis caused by Aspergillus flavus: A case report

Fatal native aortic valve fungal endocarditis caused by Aspergillus flavus: A case report

<p>Fatal Prosthetic Valve Endocarditis Due to <em>Aspergillus flavus</em> in a Diabetic Patient</p>

Biocontrol of Aflatoxins Using Non-Aflatoxigenic Aspergillus flavus: A Literature Review

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