Right atrial aspergilloma mimicking atrial mixomax

Abstract

Infective endocarditis is a serious but relatively rare infection that is associated with high morbidity and mortality rates. Aspergillus endocarditis is an uncommon entity and invasive cardiac aspergillosis is a severe and extremely life threatening disease. Prolonged use of intravascular catheters, anatomical cardiac conditions, exposure to multiple broad-spectrum antibiotics, intravenous drug abuse, and previous history of surgery are the most common risk factors of fungemia and fungal endocarditis. Diagnosis is based on the isolation of etiologic agents from cardiac and blood samples or specimens from other sterile sites or positive histopathological findings of pathologic specimens. Echocardiographic findings of endocardial involvement can lead to diagnosis. Echocardiographically, differencial diagnosis of tumor extensions, especially myxoma, atipically located bacterial vegetations, thrombus or fungal masses is very difficult as thrombi and infective verrus can mimic myxomas. Treatment of fungal endocarditis only with antifungal agents is generally unsuccessful and additional surgical intervention is usually required. In this case report we present an fungal endocarditis caused by Aspergillus species that mimicked an atrial myxoma echocardiographically in a patient who had a history of treatment with wide spectrum antibiotics for a long time. We suggest that patients who had broad spectrum antibiotic treatment for a long time should be scanned for fungal infections and if intracardiac mass is determined, fungal endocarditis should be considered in differential diagnosis. Keywords: