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Endomyocardial and pericardial aspergillosis in critically ill patients
Author(s) -
Dimopoulos George,
Frantzeskaki Frantzeska,
Kosmopoulos Marinos,
Taccone Fabio Sylvio,
Van den Abeele AnneMarie,
Bulpa Pierre,
Forêt Frederic,
Vogelaers Dirk,
Blot Stijn
Publication year - 2017
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12630
Subject(s) - aspergillosis , voriconazole , medicine , caspofungin , amphotericin b , context (archaeology) , mortality rate , itraconazole , endocardium , surgery , dermatology , antifungal , immunology , biology , paleontology
Summary Invasive aspergillosis( IA ) is a potentially lethal complication of Aspergillus infection affecting mainly immunocompromised hosts; however, during the last two decades its incidence was increasingly observed in critically ill immunocompetent patients. The objective of this study is to describe the clinical characteristics of histologically proven endomyocardial and pericardial invasion, in the context of IA , in critically ill patients. Eight critically ill patients with histopathological confirmation of endomyocardial/pericardial aspergillosis were evaluated. Risk factors, clinical and laboratory characteristics, treatment, histopathological characteristics and mortality were recorded. Signs and symptoms of cardiac dysfunction were not observed in any of the patients. Therapy was administered to six of them shortly after the first positive culture. The observed histopathological lesions included haemorrhagic lesions, small vessels with central thrombosis and surrounding consolidated tissue with necrosis. Voriconazole, caspofungin, lipid amphotericin B and itraconazole were the used antifungals. The mortality rate was high (87.5%). Endomyocardial and pericardial aspergillosis are devastating complications of invasive aspergillosis. Clinical suspicion is low making the diagnosis difficult, therefore histopathological examination of tissues are required. The mortality is high.