Case Reports Fatal Endocarditis due to Aspergillus flavus in Iran

Infective endocarditis is a rare but potentially devas-tating infection of the native endocardium and heart valves. The majority cases of infective endocarditis are caused by bacteria, whereas cardiac fungal infections account for 2-4 % of all cases of endocarditis.1 The prevalence of these infections has grown in the last decade due to intravenous drug abusing, malignant neoplasm, solid organ transplanta-tion, long term use of antibiotics as well as open-heart sur-gery which is a major factor in developing of this infec-tion.2,3 Two-thirds of cases of fungal endocarditis are caused by Candida, and one third by Aspergillus.4,5 Aspergillus endocarditis is usually associated with high morbidity and mortality, ranging from 80 % to 96%, regardless of treat-ment.6 Unfortunately, establishing a definitive diagnosis of fungal endocarditis frequently remains a problem. Thus