Multifocal Aspergillus endocarditis: Comprehensive imaging of extensive cardiac involvement in a transplant recipient

Aspergillus endocarditis is an exceedingly rare entity associated with mortality rates of 60-80% even with combined surgical and medical therapy. It most commonly occurs in immunocompromised patients or those with prosthetic cardiac devices. We present a case with unusually extensive cardiac aspergillosis affecting multiple anatomical sites rarely seen simultaneously in a single patient. Surgical management required radical debridement of infected tissue with subsequent reconstruction. This case uniquely illustrates the spectrum of pathologic involvement across multiple cardiac structures in a single patient, emphasizing both the diagnostic challenges and aggressive surgical approach necessary for survival.