Blood culture-positive Aspergillus niger native aortic valve endocarditis presenting as acute lower limb ischemia: a case report

ABSTRACT Aspergillus endocarditis is a rare, life-threatening infection in which blood cultures are almost invariably negative. We report an exceptional case of blood culture-positive native aortic valve endocarditis caused by Aspergillus niger, presenting with acute limb ischemia. Concordant isolation of A. niger from peripheral blood cultures, embolic material, and resected valve tissue provided robust microbiological confirmation. Early surgical valve replacement combined with susceptibility-guided antifungal therapy enabled prompt targeted management and a favorable clinical outcome.