Cerebral infarction due to fungal embolus

Focal neurologic signs developed in a 71 year old man after insertion of an aortic valve prosthesis. The patient died, and autopsy showed a mycotic thrombus on the prosthesis and fungal thromboemboli in branches of the coronary and left middle cerebral arteries, with infarcts in the heart and brain. Aspergillus niger was cultured from the thrombus. Only three previous cases have been reported in which focal neurologic deficits were associated with Aspergillus infection of a valve prosthesis. The present case is the first in which the pathogenesis of the neurologic abnormalities has been clearly shown to be related to fungal emboli.