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Phialemonium curvatum prosthetic valve endocarditis with an unusual echocardiographic presentation

Azriel Osherov1, Ehud Schwammenthal, Raphael Kuperstein

  • 1Heart Institute, Sheba Medical Center, Tel Hashomer, Israel, and Sackler School of Medicine, Tel Aviv University, Israel. uziosh101@hotmail.com

Echocardiography (Mount Kisco, N.Y.)
|July 15, 2006
PubMed

Insights

Phialemonium curvatum rarely causes invasive fungal infections, but can affect the heart. This case highlights the importance of repeat transesophageal echocardiography (TEE) for diagnosing prosthetic valve endocarditis.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Cardiology

Background:

  • Phialemonium species are opportunistic fungi rarely causing invasive disease in humans.
  • Invasive Phialemonium infections typically occur in immunocompromised individuals.
  • Cardiac involvement, particularly endocarditis, is exceptionally rare.

Observation:

  • A case of Phialemonium curvatum prosthetic aortic valve endocarditis is presented.
  • The initial transesophageal echocardiography (TEE) showed an unusual presentation.
  • The patient had underlying conditions predisposing to opportunistic infections.

Findings:

  • Phialemonium curvatum was identified as the causative agent of prosthetic valve endocarditis.
  • Repeat TEE revealed findings crucial for diagnosis that were not apparent initially.
  • The unusual TEE presentation complicated the initial assessment.

Implications:

  • This case underscores the diagnostic challenges posed by rare fungal pathogens like Phialemonium.
  • Repeat TEE is critical for accurate diagnosis and management of infective endocarditis, especially with atypical presentations.
  • Understanding the spectrum of Phialemonium infections is important for clinicians managing immunocompromised patients.

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