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Prosthetic valve endocarditis due to Thermomyces lanuginosus Tsiklinsky--first case report

M Lecso-Bornet1, E Gueho, G Barbier-Boehm

  • 1Service de Microbiologie, Hôpital Bichat, Paris, France.

Journal of Medical and Veterinary Mycology : Bi-Monthly Publication of the International Society for Human and Animal Mycology
|January 1, 1991
PubMed

Insights

This case report details the first instance of Thermomyces lanuginosus endocarditis on a porcine heterograft. The fungal infection followed a Staphylococcus aureus bacterial aortic valve infection, diagnosed post-mortem.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Cardiovascular Surgery

Background:

  • Endocarditis is a serious infection of the heart lining or valves.
  • Porcine heterografts are commonly used in aortic valve replacement surgery.
  • Staphylococcus aureus is a frequent cause of bacterial endocarditis.

Observation:

  • A rare case of Thermomyces lanuginosus endocarditis on a porcine heterograft is presented.
  • This fungal infection occurred secondary to Staphylococcus aureus aortic valve endocarditis.
  • Diagnosis was confirmed post-mortem via direct examination and Sabouraud's agar culture.

Findings:

  • Thermomyces lanuginosus was identified by its characteristic warty, dark brown aleurioconidia.
  • The exact route of fungal contamination remains undetermined.
  • Potential sources include operating room air or a contaminated graft.

Implications:

  • Highlights the potential for rare fungal pathogens like Thermomyces lanuginosus in prosthetic valve endocarditis.
  • Underscores the importance of sterile techniques in preventing graft contamination.
  • Suggests vigilance for fungal superinfections in patients with prosthetic valves, especially after bacterial infections.

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