Prosthetic valve endocarditis caused by Trichosporon cutaneum

Area of Science:

• Infectious Diseases
• Cardiology
• Mycology

Background:

• Fungal endocarditis is a rare but serious complication, particularly in patients with prosthetic heart valves.
• Trichosporon cutaneum is an opportunistic fungus not commonly associated with endocarditis.

Observation:

• A 58-year-old woman developed Trichosporon cutaneum endocarditis 14 months after mitral valve replacement.
• The patient had no history of antibiotic therapy prior to the fungal infection.

Findings:

• The patient was treated with ketoconazole and prosthetic valve replacement, showing initial improvement.
• Despite treatment, the patient succumbed to a subsequent aortic valve endocarditis 5 months later.
• Fungal infection was confirmed through blood cultures, pathological examination, and serological changes.

Implications:

• This case highlights the potential for rare fungal species like Trichosporon cutaneum to cause severe endocarditis in immunocompromised or prosthetic valve patients.
• Early diagnosis and aggressive antifungal therapy are crucial, but outcomes can still be poor.
• Further research is needed to understand the pathogenesis and optimal management of Trichosporon endocarditis.