Journal of Clinical Cases

Dual Valve Destructive Fungal Endocarditis

Don Zachariah

School of Medicine, Faculty of Health Sciences, North-West University, Potchefstroom, 2520, South Africa.

Corresponding Author: Don Zachariah

ABSTRACT

Fungal endocarditis is rare and highly lethal, particularly in immunocompromised patients. We report a 36-year-old woman with advanced HIV infection (CD4 45 cells/mm³) who presented with progressive heart failure following treatment for presumed pneumonia and tuberculosis. Transthoracic and transoesophageal echocardiography demonstrated large vegetations on both the aortic and pulmonary valves, severe regurgitation, and an aortic root-to-right ventricular fistula. Blood cultures remained negative. Urgent surgery with metallic aortic and bioprosthetic pulmonary valve replacement was performed. Valve cultures subsequently grew Aspergillus fumigatus. Despite intensive antifungal therapy, the patient died post-operatively from methicillin-resistant Staphylococcus aureus infection, highlighting the aggressive course of dual-valve disease. .