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Scopulariopsis endocarditis associated with Duran ring valvuloplasty

L O Gentry1, M M Nasser, M Kielhofner

  • 1Infectious Disease Section, St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.

Texas Heart Institute Journal
|January 1, 1995
PubMed
Summary

This study reports the first case of fungal endocarditis caused by Scopulariopsis brevicaulis. The rare infection occurred in a patient with a prosthetic mitral valve, highlighting a new etiological agent for this serious condition.

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Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Cardiology

Background:

  • Fungal endocarditis is a rare but serious infection, typically caused by Aspergillus and Candida species.
  • Patients with prosthetic heart valves are at increased risk for endocarditis.

Observation:

  • A patient with a history of mitral valve disease and a prosthetic Duran ring presented with endocarditis.
  • Scopulariopsis brevicaulis was identified as the causative agent from a vegetation on the mitral valve.

Findings:

  • This is the first reported case of endocarditis caused by Scopulariopsis brevicaulis.
  • Surgical mitral valve replacement with a St. Jude mechanical prosthesis was performed.
  • Treatment involved amphotericin B, followed by oral itraconazole based on susceptibility testing.

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Implications:

  • This case expands the spectrum of fungi implicated in endocarditis.
  • It underscores the importance of considering less common fungal pathogens in prosthetic valve endocarditis.
  • Antifungal susceptibility testing is crucial for guiding effective treatment of Scopulariopsis endocarditis.