We report the post-mortem findings of the case of a 31-year-old male who, through sexual contacts with a female drug addict, was found to be HIV-positive and developed the acquired immunodeficiency syndrome (AIDS) 2 years later. He was treated for various opportunistic infections over the next 7 years when he presented with cardiac abnormalities and multiple cerebral lesions which were responsible for his death. The results revealed Aspergillus fumigatus endocarditis and myocarditis with mycotic thromboembolic extension to the brain, spleen, kidney and pancreas. We review the literature of Aspergillus infection in patients with AIDS and more specifically cardiac involvement with this pathogen.