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Infective endocarditis caused by Paecilomyces varioti

S B Kalish, R Goldschmidt, C Li

    American Journal of Clinical Pathology
    |August 1, 1982
    PubMed
    Summary
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    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.

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    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.