Trichosporon Cutaneum Endocarditis

Abstract
A 61 yr old man with T. cutaneum prosthetic valve endocarditis is reported. He had an aortic valve replacement for rheumatic heart disease 3 yr 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. Of 17 blood cultures taken over 3 wks, 3 were positive for T. cutaneum. He was given amphotericin B (AmB) and 5-fluorocytosine (5FC); T. cutaneum infection of the 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.

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