Buğra HARMANDAR, Serap ŞİMŞEK, Ahmet ŞAŞMAZEL, İlker Kemal YÜCEL, Numan Ali AYDEMİR, Ali Rıza KARACI

Aspergillus endocarditis in a patient with acute lymphoblastic leukemia

Aspergillus endokarditi hayati tehlike oluşturan bir durumdur. Tanı ve tedavisi oldukça zordur. İmmün sistemi baskılanmış hastalarda alınan kan kültürlerinin negatif olması ve ekokardiyografide vejetasyon görülmesi durumunda Aspergillus endokarditinden şüphelenilmelidir. Bu hastalarda kesin tanı, doku histolojisi ve kültürü ile yapılır. Tedavide en iyi yaklaşım agresifcerrahi debridmanı ile birlikte uzun süreli antifungaltedavi uygulanmasıdır. Bu makalede immün yetersizlik nedeniyle Aspergillus endokarditi gelişen akut lenfoblastik lösemili 5.5 yaşında bir erkek olgu sunuldu. HastayaRoss ameliyatı ile birlikte sol ventrikül çıkım yolundakigeniş vejetasyonun ekzisyonu uygulandı. Ancak, takip süresinde gelişen muhtemel intraserebral apselere bağlıolarak hasta kaybedildi.

Akut lenfoblastik lösemili bir hastada aspergillus endokarditi

Aspergillus endocarditis is a life-threatening condition.Establishment of the diagnosis and treatment remainhighly challenging. Aspergillus endocarditis should besuspected in immunocompromised patients with negativeblood cultures and vegetation on echocardiography.Definitive diagnosis is based on tissue histology andculture. The best treatment approach requires aggressivesurgical debridement in combination with prolongedantifungal therapy. In this article, we report a 5.5-year-old boy with acute lymphoblastic leukemia in whomimmunosuppression-related Aspergillus endocarditisdeveloped. The patient underwent a Ross operation andexcision of a large vegetation in the left ventricular outflowtract. However, he died due to possible intracerebralabscesses during follow-up.

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