{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T10:20:08Z","timestamp":1791800408101,"version":"4.3.4"},"reference-count":55,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Background: Aspergillus endocarditis is a rare but life-threatening form of infective endocarditis that typically occurs in patients with a history of cardiac surgery, prosthetic valve implantation, or profound immunosuppression. Native valve involvement in non-traditional hosts remains exceptionally rare and is diagnostically challenging. Case presentation: We describe a 56-year-old woman with CREST syndrome and advanced liver disease awaiting transplantation who developed native aortic valve endocarditis. Blood cultures and serum biomarkers (galactomannan and \u03b2-d-glucan) were also negative. Transthoracic echocardiography revealed vegetation on the aortic valve. Valve replacement was performed, and Aspergillus fumigatus was isolated from two valve cultures. Liposomal amphotericin B was initiated; however, the patient died of multiorgan failure two weeks later. Systematic review: To contextualise this case, we conducted a systematic review of the literature following the PRISMA guidelines. We included microbiologically confirmed cases of native valve Aspergillus endocarditis based on valve or embolic tissue analysis. Forty-three studies met the inclusion criteria, comprising 45 patients in total. Data were independently extracted by two reviewers and narratively synthesised due to clinical heterogeneity. Conclusions: This case illustrates the diagnostic and therapeutic challenges of native-valve Aspergillus endocarditis in patients without classical risk factors for the disease. Early imaging and a high index of suspicion are crucial for diagnosis. Combined surgical and antifungal therapy remains the cornerstone of management, although the mortality rate remains high.<\/jats:p>","DOI":"10.3390\/jof11120836","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T11:43:22Z","timestamp":1764157402000},"page":"836","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Aspergillus Endocarditis in Native Valves in Non-Traditional Hosts: A Systematic Review of a Case in a Patient with CREST Syndrome and Advanced Liver Cirrhosis"],"prefix":"10.3390","volume":"11","author":[{"given":"Leticia","family":"Espinosa-del-Barrio","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Sant Joan d\u2019Alacant University Hospital, 03550 Sant Joan d\u2019Alacant, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elia","family":"G\u00f3mez G. de la Pedrosa","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Department, Ram\u00f3n y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelia","family":"\u00c1lvarez-D\u00edaz","sequence":"additional","affiliation":[{"name":"Medical Library, Ram\u00f3n y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6526-5873","authenticated-orcid":false,"given":"Javier","family":"Guzm\u00e1n Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Sant Joan d\u2019Alacant University Hospital, 03550 Sant Joan d\u2019Alacant, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Dolores","family":"Corbacho Loarte","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Ram\u00f3n y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5736-8111","authenticated-orcid":false,"given":"Rosa","family":"Escudero S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Ram\u00f3n y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Mart\u00edn-D\u00e1vila","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Ram\u00f3n y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6959-5263","authenticated-orcid":false,"given":"Jes\u00fas","family":"Fort\u00fan Abete","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Ram\u00f3n y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9231-7421","authenticated-orcid":false,"given":"Javier","family":"Cobo Reinoso","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Ram\u00f3n y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Pintado Garc\u00eda","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Ram\u00f3n y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Gioia","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Ram\u00f3n y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Thompson, G.R., Jenks, J.D., Baddley, J.W., Lewis, J.S., Egger, M., Schwartz, I.S., Boyer, J., Patterson, T.F., Chen, S.C., and Pappas, P.G. 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