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Infective endocarditis caused by Paecilomyces varioti
Abstract:
The first reported case of Paecilomyces varioti endocarditis occurring on a porcine heterograft prosthesis is presented and the clinical and pathological features described in the four previously reported cases of prosthetic valvular endocarditis caused by this organism are reviewed. In each case, infection became apparent more than two months after cardiac surgery. Three of the four patients with infected aortic prosthesis developed outflow obstruction secondary to valvular vegetations. All patients died regardless of medical or surgical intervention. Appropriate therapy remains unknown.
Insights
This study reports the first case of Paecilomyces varioti endocarditis on a porcine heterograft. Despite interventions, all patients with this rare fungal infection died, highlighting an urgent need for effective therapies.
Area of Science:
- Cardiology
- Infectious Diseases
- Mycology
Background:
- Prosthetic valvular endocarditis (PVE) poses significant risks following cardiac surgery.
- Paecilomyces varioti is an uncommon fungal pathogen, rarely implicated in endocarditis.
Observation:
- Presents the first documented case of P. varioti endocarditis on a porcine heterograft prosthesis.
- Reviews four prior cases of P. varioti PVE, all occurring >2 months post-surgery.
- Three patients with aortic prosthesis infection developed critical outflow obstruction due to vegetations.
Findings:
- All reported patients with P. varioti PVE, including the new case, experienced fatal outcomes.
- Medical and surgical treatments were ineffective in preventing mortality.
- The optimal therapeutic strategy for this specific fungal endocarditis remains undetermined.
Implications:
- Highlights the severe prognosis of P. varioti endocarditis, particularly on prosthetic valves.
- Underscores the critical need for research into effective antifungal treatments for P. varioti PVE.
- Suggests vigilance for fungal infections in patients with prosthetic heart valves presenting late after surgery.