ENDOCARDITIS DUE TO ASPERGILLUS-FLAVUS

Fungal endocarditis has emerged as an important complication of patien ts undergoing cardiovascular surgery. Our patient had no past history of cardiac surgery, intravenous drug abuse or immunosuppressive therap y. He had received broad-spectrum antibiotics for varying periods, whi ch might have predisposed him to this infection. The diagnosis was bas ed on the demonstration of hyaline, septate branched fungal elements i n the infected valvular tissue and isolation of Aspergillus flavus in culture. The delay in establishing the ante-mortem diagnosis because o f repeatedly negative blood cultures, presence of disseminated intrava scular coagulopathy and rapidly deteriorating kidney function were the major factors contributing to his poor prognosis and death, despite s urgical removal of infected valves and antifungal therapy. This is the first report of endocarditis due to A. flavus from the Middle East.