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Trichosporon cutaneum endocarditis

R Marier, B Zakhireh, J Downs

Scandinavian Journal of Infectious Diseases

|January 1, 1978

Summary

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This case report details a Trichosporon cutaneum prosthetic valve endocarditis in a patient with a history of aortic valve replacement. In vitro studies showed synergistic effects of antifungal combinations.

Area of Science:

Infectious Diseases
Cardiology
Mycology

Background:

Prosthetic valve endocarditis (PVE) poses significant clinical challenges.
Trichosporon cutaneum is an opportunistic fungal pathogen.
Rheumatic heart disease can necessitate aortic valve replacement, increasing PVE risk.

Observation:

A 61-year-old male presented with subacute onset of symptoms following aortic valve replacement.
Clinical manifestations included a new systolic murmur, conjunctival hemorrhages, hematuria, and neurological deficits.
Blood cultures confirmed Trichosporon cutaneum fungemia.

Findings:

The patient was diagnosed with Trichosporon cutaneum prosthetic aortic valve endocarditis.
Despite treatment with amphotericin B and 5-fluorocytosine, and subsequent valve replacement, the patient experienced refractory ventricular fibrillation and expired.

Related Experiment Videos

In vitro testing demonstrated synergistic antifungal activity with amphotericin B-5-fluorocytosine and amphotericin B-rifampin combinations.

Implications:

This case highlights the potential for Trichosporon cutaneum to cause severe PVE.
Aggressive antifungal therapy and surgical intervention are crucial for managing PVE.
In vitro synergy data may inform future therapeutic strategies for refractory fungal endocarditis.