{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T01:09:59Z","timestamp":1793149799137,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":268,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Infectious Diseases"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    <jats:italic>Aspergillus<\/jats:italic>\n                    endocarditis (AE) is a rare but life\u2010threatening form of infective endocarditis, accounting for only 0.2% of cases. Despite antifungal and surgical treatment, AE remains a major diagnostic and therapeutic challenge with high mortality rates. Ibrutinib, a Bruton\u2019s tyrosine kinase inhibitor used in the treatment of chronic lymphocytic leukemia (CLL), has been associated with early\u2010onset invasive aspergillosis. However, no cases of AE have been documented in patients undergoing ibrutinib therapy to date.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case Presentation:<\/jats:bold>\n                    A 71\u2010year\u2010old man with relapsed CLL on third\u2010line ibrutinib therapy and a history of arrhythmic cardiomyopathy requiring an implantable cardioverter\u2010defibrillator (ICD) presented with a six\u2010month history of fever, cough, and fatigue. On admission, a full\u2010body computed tomography scan revealed intestinal ischemia and multiple thrombotic occlusions involving the kidney, spleen, and iliac artery. Markedly elevated beta\u2010D\u2010glucan and serum galactomannan levels prompted empirical initiation of isavuconazole. Transthoracic echocardiography identified a large vegetation (2.5\u2009\u00d7\u20094\u2009cm) on the mitral valve with ICD lead involvement. Despite urgent surgical intervention\u2014including ICD extraction and mitral valve replacement\u2014the patient succumbed to complications. Intraoperative valve cultures grew\n                    <jats:italic>Aspergillus fumigatus.<\/jats:italic>\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    This report underscores the severity of AE despite combined surgical and antifungal therapy. Given its high mortality rates, clinicians should maintain a high index of suspicion for AE, particularly in immunocompromised patients or those with a history of cardiac surgery or implanted cardiac devices. Early recognition and aggressive intervention remain essential to improving outcomes.\n                  <\/jats:p>","DOI":"10.1155\/crdi\/6863015","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T07:19:53Z","timestamp":1758871193000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["<i>Aspergillus<\/i>\n                    Endocarditis: A Rare but Serious Complication During Treatment With Ibrutinib"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5652-3204","authenticated-orcid":false,"given":"Luca","family":"Mezzadri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria Giuseppina Chiara","family":"Caramma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene 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