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Lecythophora mutabilis prosthetic valve endocarditis in a diabetic patient
Marci Drees1, Brian L Wickes, Mamta Gupta
1Division of Geographic Medicine & Infectious Diseases, Department of Medicine, Tufts-New England Medical Center, Boston, Massachusetts 02111, USA.
Abstract:
While dematiaceous (dark-walled) fungi are ubiquitous in the environment, their involvement in invasive human infections has rarely been reported. However, these organisms have been identified as potential emerging pathogens, particularly among immunocompromised hosts. We describe a diabetic patient with Lecythophora mutabilis prosthetic valve endocarditis who was treated surgically, as well as with amphotericin B lipid complex and voriconazole, which were subsequently followed by prolonged voriconazole suppressive therapy. To the best of our knowledge, our patient is the first reported survivor of L. mutabilis prosthetic valve endocarditis.
Insights
Dematiaceous fungi rarely cause invasive infections, but can be emerging pathogens in immunocompromised individuals. This case report details the first successful treatment of Lecythophora mutabilis prosthetic valve endocarditis.
Area of Science:
- Mycology
- Infectious Diseases
- Cardiology
Background:
- Dematiaceous fungi, characterized by dark cell walls, are widespread environmental organisms.
- Invasive infections by these fungi are uncommon but increasingly recognized, especially in immunocompromised patients.
- Lecythophora mutabilis is a dematiaceous fungus with limited reported human pathogenicity.
Observation:
- A diabetic patient developed prosthetic valve endocarditis caused by Lecythophora mutabilis.
- The patient underwent surgical intervention for the endocarditis.
- Treatment involved amphotericin B lipid complex and voriconazole, followed by suppressive voriconazole therapy.
Findings:
- The patient is the first reported survivor of Lecythophora mutabilis prosthetic valve endocarditis.
- Successful management involved a combination of surgical and antifungal therapies.
- This case highlights the potential for L. mutabilis to cause severe invasive disease.
Implications:
- This case expands the understanding of dematiaceous fungi as potential human pathogens.
- It underscores the importance of considering rare fungal infections in immunocompromised individuals.
- The successful treatment strategy may inform future management of similar invasive fungal endocarditis cases.
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