title: Torulopsis glabrata endocarditis complicating aortic homograft valve treated with 5-fluorocytosine: case report with discussion of antifungal chemotherapy.
abstract: A case of Torulopsis glabrata endocarditis occurring in a patient 14 months after aortic homograft valve replacement is reported. The infection was not controlled by amphotericin B which led to progressive renal impairment. Re-operation was delayed by the development of multiple infarctions due to coronary emboli. The infection was subsequently eradicated by oral treatment with the newer antifungal agent, 5-fluorocytosine, but death of the patient eventually occurred from an arrhythmia related to the persisting myocardial failure consequent upon episodes of transmural infarction. Current evidence favours the use of early re-operation in all cases of endocarditis in addition to aggressive chemotherapy with a combined regime of amphotericin B and 5-fluorocytosine. Clinical pharmacology of 5-fluorocytosine is briefly discussed.
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D001021:Aortic Valve / Q000637:transplantation*; D001024:Aortic Valve Stenosis / Q000601:surgery; D001344:Autopsy; D002175:Candida; D002177:Candidiasis / Q000188:drug therapy*; D003596:Cytosine / Q000031:analogs & derivatives*; D004696:Endocarditis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005437:Flucytosine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D011183:Postoperative Complications / Q000188:drug therapy*; D014184:Transplantation, Homologous
chemical_list: D000666:Amphotericin B; D003596:Cytosine; D005437:Flucytosine