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Phialophora mutabilis endocarditis

M Slifkin, H M Bowers

    American Journal of Clinical Pathology
    |January 1, 1975
    PubMed
    Summary
    This summary is machine-generated.

    This study reports the first case of fungal endocarditis caused by Phialophora mutabilis on a prosthetic mitral valve. The infection led to valve obstruction and patient death, highlighting a rare but serious complication of prosthetic heart valves.

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    Area of Science:

    • Mycology
    • Cardiology
    • Infectious Diseases

    Background:

    • Fungal endocarditis is a rare but serious infection of heart valves.
    • Prosthetic heart valves are susceptible to fungal colonization.
    • Phialophora mutabilis is a dematiaceous fungus not previously implicated in endocarditis.

    Purpose of the Study:

    • To report the first case of fungal endocarditis caused by Phialophora mutabilis on a prosthetic mitral valve.
    • To describe the clinical presentation, diagnosis, and outcome of this rare infection.
    • To characterize the morphology and pathogenicity of the isolated Phialophora mutabilis strain.

    Main Methods:

    • Case report of a patient with rheumatic heart disease and prosthetic valves.
    • Surgical explantation of the prosthetic mitral valve with vegetation analysis.

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  • Microscopic and cultural identification of the causative fungus.
  • Inoculation of Phialophora mutabilis into cortisone-treated and untreated mice.
  • Main Results:

    • A large, obstructive fungal vegetation of Phialophora mutabilis was found on the prosthetic mitral valve.
    • The patient developed congestive heart failure and died postoperatively.
    • Phialophora mutabilis exhibited variations in morphology and pigmentation.
    • Cortisone-treated mice showed higher mortality rates after inoculation compared to untreated mice.

    Conclusions:

    • Phialophora mutabilis can cause severe fungal endocarditis on prosthetic heart valves.
    • Early diagnosis and aggressive management are crucial for improving outcomes.
    • Further research is needed to understand the pathogenicity and treatment of Phialophora mutabilis infections.