Curvularia alcornii Infection

This case report describes a 53-year-old man presenting with acute lower limb paralysis and fever two months after bioprosthetic aortic-valve replacement. CT angiography revealed a 9-cm ascending aortic pseudoaneurysm and systemic emboli. Histopathology and fungal culture identified Curvularia alcornii, a dematiaceous soil fungus. Despite initial antifungal treatment with liposomal amphotericin B and voriconazole and surgical replacement of the aortic root, the patient later developed new iliac pseudoaneurysms and died from disseminated fungal infection. The case highlights the diagnostic and management challenges of rare fungal endocarditis and aortitis following valve replacement in immunocompetent hosts, particularly in environmental exposure contexts.

This case report describes a 53-year-old man presenting with acute lower limb paralysis and fever two months after bioprosthetic aortic-valve replacement. CT angiography revealed a 9-cm ascending aortic pseudoaneurysm and systemic emboli. Histopathology and fungal culture identified Curvularia alcornii, a dematiaceous soil fungus. Despite initial antifungal treatment with liposomal amphotericin B and voriconazole and surgical replacement of the aortic root, the patient later developed new iliac pseudoaneurysms and died from disseminated fungal infection. The case highlights the diagnostic and management challenges of rare fungal endocarditis and aortitis following valve replacement in immunocompetent hosts, particularly in environmental exposure contexts.