Trichosporon cutaneum endocarditis.
A 61-year-old man with Trichosporon cutaneum (T. cutaneum) prosthetic valve endocarditis is reported. He had had an aortic valve replacement for rheumatic heart disease 3 years earlier. Onset of the valve infection was subacute. A systolic murmur was noted on admission. Subsequently, he developed conjunctival hemorrhages, hematuria and transient episodes of confusion, aphasia and cranial nerve palsies. Three of 17 blood cultures taken over 3 weeks were positive for T. cutaneum. He was given amphotericin B (AmB) and 5-fluorocytosine (5FC); T. cutaneum infection of prosthetic aortic valve was identified. The aortic valve was replaced. Postoperatively he developed refractory ventricular fibrillation and died. Striking synergy to AmB-5FC and AmB-rifampin combinations was demonstrated in vitro.
D000666:Amphotericin B / Q000627:therapeutic use; D001021:Aortic Valve / Q000601:surgery; D003453:Cryptococcosis / Q000188:drug therapy / Q000382:microbiology*; D003454:Cryptococcus / Q000302:isolation & purification; D004698:Endocarditis, Subacute Bacterial / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D005437:Flucytosine / Q000627:therapeutic use; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged
D000666:Amphotericin B; D005437:Flucytosine