It’s not just leg pain: An unusual presentation of Aspergillus | 52037
Clinical & Experimental Cardiology

Clinical & Experimental Cardiology
Open Access

ISSN: 2155-9880

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It’s not just leg pain: An unusual presentation of Aspergillus endocarditis

5th International Conference on Clinical & Experimental Cardiology

April 27-29, 2015 Philadelphia, USA

Supakanya Wongrakpanich1, Suramath Isaranuwatchai2, Parichart Junpaparp1, Wikrom Chaiwatcharayut1 and Sarawut Siwamogsatham3

Posters-Accepted Abstracts: J Clin Exp Cardiolog

Abstract :

Aspergillus species is a rare organism causing infective endocarditis (IE). Septic embolization from IE to large artery is also uncommon manifestation. We are reporting a native valve Aspergillus endocarditis, presented with acute femoral artery embolism. A 62-year-old healthy male presented with sudden-onset of right lower extremity pain, associated with weakness and numbness for three hours. Physical examination revealed cold clammy skin of his right leg with absent of pulse distal to popliteal artery. Cardiovascular exams showed grade 3/6 pansystolic murmur at apex, radiated to axillary area. A Roth?s spot was noted on eye exams. With highly suspicious of acute arterial occlusion caused limb ischemia, the computerized tomography with angiography was performed, which showed total occlusion at distal right common femoral artery. Patient underwent emergent embolectomy via right common femoral artery. Subsequent pathological result showed fungal emboli, morphologically microscopic apperance was consistent with Aspergillus spp. A Subsequent report of blood culture confirmed AspergillusFumigatus. Transesophageal echocardiogram revealed moderately severe mitral valve regurgitation with 7x9 mm oscillating vegetation attached at anterior leaflet of mitral valve. The diagnosis of Aspergillus infective endocarditis with acute femoral arterial occlusion due to fungal emboli was established. The patient was successfully treated with anti-fungal therapy (Amphotherecin B and Voriconazole) and mitral valve replacement. We hereby report a case of Aspergillus endocarditis in native valve patient. This case is interesting in aspects of a rare involved organism, lack of established risk factors and unusual manifestation of large septic embolism attributed to acute ischemia of entire limb.

Biography :

Supakanya Wongrakpanich, MD. graduated from Chulalongkorn University, Thailand. She is currently an Internal Medicine resident at Einstein Medical center, Philadelphia. She has published 5 papers in reputed journals, 2 Poster presentations, and 2 accepted articles for publication.