ASPERGILLUS PROSTHETIC VALVE ENDOCARDITIS, BRAIN ABSCESS AND AORTIC ROOT REPLACEMENT BY HOMOGRAFT

Abstract

A 22- year-old male with history of aortic prosthetic valve replacement 3 months prior to admission was operated on emergently due to prosthetic valve endocarditis (PVE) unresponsive to medical therapy with a large mobile vegetational mass extending to LV. On operation there was a large friable vegetational mass engulfing the mechanical prosthetic valve. The partially detached prosthetic valve and vegetations were removed and aortic root replacement by aortic Homograft and coronaries implantation were performed. The patient was discharged from ICU four days after operation with good condition. The result of two cultures from the prosthetic valve was Aspergillus. Amphotericine-B was started and all other antibiotics were discontinued. The patient remained afebrile and in good condition but CT scan of brain revealed three SOL in frontal and occipital lobes. This case suggests that early and proper surgical treatment may reduce the risk of complications and mortality