Polymerase chain reaction aids in the diagnosis of an unusual case of Aspergillus niger endocarditis in a patient with acute myeloid leukaemia

Endocarditis secondary to Aspergillus niger has not been described in a leukaemic patient. We describe a case of A. niger endocarditis in a patient with acute myeloid leukaemia and refractory fever. The microbiological cause of his endocarditis was initially misdiagnosed because he fulfilled the Duk...

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Bibliographic Details
Published in:The Journal of infection 2003-11, Vol.47 (4), p.344-347
Main Authors: McCracken, D, Barnes, R, Poynton, C, White, P.L, Işik, N, Cook, D
Format: Article
Language:English
Subjects:
Aspergillosis - diagnosis
Aspergillosis - microbiology
Aspergillus niger
Aspergillus niger - isolation & purification
Biological and medical sciences
Cardiology. Vascular system
DNA, Fungal - analysis
Endocardial and cardiac valvular diseases
Endocarditis
Endocarditis - diagnosis
Endocarditis - microbiology
Fatal Outcome
Heart
Human viral diseases
Humans
Infectious diseases
Leukaemia
Leukemia, Myeloid, Acute - complications
Male
Medical sciences
Middle Aged
Polymerase Chain Reaction - methods
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:Endocarditis secondary to Aspergillus niger has not been described in a leukaemic patient. We describe a case of A. niger endocarditis in a patient with acute myeloid leukaemia and refractory fever. The microbiological cause of his endocarditis was initially misdiagnosed because he fulfilled the Duke criteria for enterococcal endocarditis. A polymerase chain reaction test utilizing pan-fungal primers detected a product from an Aspergillus sp. The DNA was subsequently sequenced and was found to have 100% homology with A. niger. A postmortem revealed fungal endocarditis secondary to disseminated aspergillosis, without evidence of bacterial endocarditis. The patient was found to have a lung aspergilloma that was possibly occupationally acquired, and may have been long standing.
ISSN:0163-4453
1532-2742
DOI:10.1016/S0163-4453(03)00084-7