title: A rare case of infective endocarditis complicated by Trichosporon asahii fungemia treated by surgery.
abstract: The patient was a 58-year-old male. He consulted our hospital because of weight loss and fever. Computed tomography (CT) revealed renal infarction. Nine days after admission, CT showed hemorrhagic cerebral infarction in the right frontal lobe. A blood culture revealed streptococcus oralis, and echocardiography revealed vegetation in the mitral and aortic valves, suggesting infective endocarditis (IE). Fever (39 degrees C or higher) was noted 23 days after admission. A blood culture revealed Trichosporon asahii (T. asahii), suggesting T. asahii fungemia. An intravenous drip of fluconazole at 400 mg/day was initiated, and two-valve replacement was performed 34 days after admission. Following surgery, the patient became negative for beta-D glucan and was discharged 85 days after admission. We report the present case of IE complicated by T. asahii fungemia, which is rare in patients other than malignant blood disease or tumor patients, showing a poor prognosis in which survival was achieved by surgery.
authors.affiliation: Division of Cardiovascular Surgery, Sasebo City General Hospital, Nagasaki, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Izumi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hisata
authors.forename: Shiro
authors.initials: S
authors.lastname: Hazama
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D001021:Aortic Valve / Q000382:microbiology / Q000601:surgery*; D003131:Combined Modality Therapy; D004452:Echocardiography; D004696:Endocarditis / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D015725:Fluconazole / Q000008:administration & dosage; D005839:Gentamicins / Q000008:administration & dosage; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000382:microbiology / Q000601:surgery*; D009181:Mycoses / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D019533:Streptococcus oralis / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014250:Trichosporon / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D005839:Gentamicins; D015725:Fluconazole