title: [Successful drug therapy in Aspergillus endocarditis].
abstract: A 74-year-old man who had a weight loss of 7 kg in three months, with fever up to 38 degrees C and anaemia (Hb 9.4 g/dl) began to have pain and blue discoloration of fingers II-V of the right hand. Echocardiography demonstrated vegetation on the aortic valve cusps and blood culture grew Aspergillus fumigatus, indicating Aspergillus endocarditis. There were no predisposing factors. Valve replacement was contraindicated because of the age of the patient, the presence of peripheral arterial disease, and previous myocardial infarction. Treatment was started with amphotericin B i.v. (dosage increasing to 50 mg daily) and 1.5 g daily of flucytosine by mouth, to a total of 1.1 g amphotericin B and 41.5 g flucytosine in five weeks. During this time there was a gradual decrease in symptoms and the valve vegetations. Nine months later there has been no recurrence.
authors: Medizinische Poliklinik, Universität München.
authors: J R
authors: JR
authors: Bogner
authors: S
authors: S
authors: Lüftl
authors: M
authors: M
authors: Middeke
authors: F
authors: F
authors: Spengel
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage; D000671:Amputation, Surgical; D001021:Aortic Valve; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D003131:Combined Modality Therapy; D003881:Dermatomycoses / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D004359:Drug Therapy, Combination; D004696:Endocarditis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D005385:Fingers / Q000601:surgery; D005437:Flucytosine / Q000008:administration & dosage; D006229:Hand Dermatoses / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008297:Male
chemical_list: D000666:Amphotericin B; D005437:Flucytosine
vernacular_title: Erfolgreiche medikamentöse Therapie einer Aspergillen-Endokarditis.