Bioprosthetic endocarditis due to Cryptococcus neoformans.
Fungal prosthetic endocarditis continues to be a lethal complication of cardiac valve replacement. We describe a patient with culture-proved Cryptococcal endocarditis and myocarditis whose non-regurgitant xenograft aortic prosthesis was successfully replaced urgently upon the occurrence of new 1st degree A-V block in the third postoperative week. Operative intervention, including vigorous debridement of the aortic root, is effective in postoperative prosthetic fungal infections involving the myocardium. The patient described herein is now infection-free, with a non-regurgitant valve, one and one-half years following operation.
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D001021:Aortic Valve / Q000601:surgery; D001705:Bioprosthesis / Q000009:adverse effects*; D003453:Cryptococcosis / Q000188:drug therapy / Q000209:etiology*; D004359:Drug Therapy, Combination; D004696:Endocarditis / Q000209:etiology* / Q000628:therapy; D005437:Flucytosine / Q000627:therapeutic use; D006327:Heart Block / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D012086:Reoperation
D000666:Amphotericin B; D005437:Flucytosine