Table 1.

Summary of case reports of Aspergillus fumigatus endocarditis

Case report (reference number)	Initial patient presentation	Immune-compromised status	Valve affected on echo	Complication	Blood culture result	Early surgical intervention	Treatment	Outcome
1.20	A 53-year-old male patient with multilobar nodular pneumonia	No	Native tricuspid valve	Pulmonary septic emboli	Negative	None	Intravenous AMB.	Patient passed away 16 days after admission while on antifungal therapy.
2.21	A 68-year-old man with cavitary pneumonia, involving left lung	Yes	Native mitral valve	Multiple liver abscesses, brain haemorrhage, acute renal failure, and endophthalmitis	Negative	Mitral valve vegetectomy	Initial treatment with micafungin, which was switched to AMB and subsequently voriconazole.	Patient survived with no sign of recurrence after 24 months follow-up.
3.22	An 18-year-old man status post bone marrow transplantation, chronic pneumonia	Yes	Native tricuspid valve extending into right atrium, interatrial septum and superior vena cava, and pacemaker wire.	None	Negative	Valvuloplasty and pacemaker removal	Intravenous course of voriconazole followed by indefinite oral voriconazole.	Patient survived with no sign of recurrence after 6 months follow-up.
4.23	A 65-year-old man with intermittent fever for 4 months	No	Native Tricuspid valve and interatrial septum	None	Negative	Valvuloplasty	Intravenous course of voriconazole followed by indefinite oral voriconazole.	Patient survived with no sign of recurrence after 6 months follow-up.
5.24	An 8 month-old infant status post liver transplantation, pneumonia with A. fumigatus	Yes	Native mitral valve chordae and papillary muscle, interventricle septum, left lateral ventricular wall, and apical right ventricle	None	Negative	None	Combination of voriconazole plus caspofungin; subsequently. AMB was added due to no clinical response. Her treatment followed by indefinite oral voriconazole.	Patient survived with no sign of recurrence after 20 months follow-up.
6.25	A 52-year-old man status post pancreas-kidney transplantation, pneumonia	Yes	Native tricuspid valve anterior leaflet	Diffuse pulmonary septic emboli with pleural-based wedge-shaped lesions	Negative	Tricuspid valve replacement	Caspofungin plus oral voriconazole and aerosolized AMB deoxycholate.	Patient passed away from fatal haemoptysis 61 days after valve replacement surgery while still on antifungal therapy.
7.26	A 57-year-old man with a myocardial infarction, and cardiogenic shock found to have A. fumigatus endocarditis.	Yes	Native mitral valve anterior leaflet	Left circumflex coronary artery and first obtuse marginal artery mycotic aneurysms	Positive	Mitral valve replacement	Liposomal AMB, plus caspofungin. Voriconazole was only added during the first week of therapy.	Patient survived with no sign of recurrence after 3 months follow-up.
8.18	A 25-year-old man with pneumonia and haemoptysis.	No	Native tricuspid valve	Septic pulmonary emboli	Negative	Valvuloplasty	Liposomal AMB and oral voriconazole followed by suppressive treatment for 6 months with oral voriconazole.	Patient survived with no sign of recurrence after 6 months follow-up.
9.27	A 32-year-old man status post renal transplantation, thromboembolic events involving renal, iliac and common femoral arteries	Yes	Native mitral valve, posterior leaflet	Spondylodiscitis and cutaneous lesions	Negative	None (planned intention was to undergo surgical valve replacement)	Intravenous AMB for 12 days.	Patient passed away prior to surgical intervention.
10.28	A 64-year-old man with blurry vision, erythematous and swollen right eye, associated with tender nodules on his right palm (Osler's nodes)	Yes	Native aortic valve	Endophthalmitis	Negative	Aortic valve replacement	Intraocular AMB and intravenous liposomal AMB.	Patient survived with no sign of recurrence after 18 months follow-up.
11.29	A 10 month-old infant with acute respiratory distress 3 months after cardiac surgery.	No	Non-valvular. Vegetation on inferior aspect of ventricular septal defect patch.	Acute hepatic and renal failure with septic emboli and abscess formation	Negative	Surgical debridement and repair	Liposomal AMB plus flucytosine.	Patient survived with no sign of recurrence after 15 months follow-up.
12.30	A 66-year-old man with decreased vision and pain in the left eye, severe pain in the left calf followed by numbness and weakness in the left foot	No	Native mitral valve, subsequently recurrence with the prosthetic mitral valve involvement (post valve replacement)	Left femoral artery septic embolus	Negative	Mitral valve replacement	Intravenous AMB and. oral flucytosine. The second medication (flucytosine) was discontinued 4 days postoperation.	Patient passed away due to recurrence of endocarditis following valve replacement.
13.31	A 13-year-old woman with fever, acute severe pain of the right lower extremity	No	Prosthetic mitral valve	Septic emboli to the brain, right common iliac and femoral arteries	Negative	Mitral prosthetic valve replacement	Intravenously AMB.	Patient passed away 13 days after admission while on antifungal therapy.