Aspergillus endocarditis Presenting as Massive Peripheral Embolism Following Open Heart Surgery.

Abstract: Fungal endocarditis is rare but potentially a lethal condition. Large bulky vegetations are common and can present as peripheral thromboembolism. We report a case of a 73-year-old man who had an uneventful aortic valve replacement and coronary artery bypass grafting. He was readmitted with embolic occlusion of lower limb vessels. This was treated with embolectomy. Investigations suggested a ‘thrombus’ in the ascending aorta, which during surgery revealed itself to be aspergillosis. Obtaining a histopathology of the removed embolus is often omitted in cases of embolic occlusion of lower limb arteries as the source is nearly always a thrombus. Uncommonly, infective endocarditis can be the source of peripheral embolism and hence histopathology and microbiology of the embolus should be obtained if it appears different as the prognosis is better if treated early and aggressively. [Copyright &y& Elsevier]