Marier R, Zakhireh B, Downs J, Wynne B, Hammond G L, Andriole V T
Scand J Infect Dis. 1978;10(3):225-6.
A 61-year-old man with Trichosporon cutaneum (T. cutaneum) prosthetic valve endocarditis is reported. He had had an aortic valve replacement for rheumatic heart disease 3 years 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. Three of 17 blood cultures taken over 3 weeks were positive for T. cutaneum. He was given amphotericin B (AmB) and 5-fluorocytosine (5FC); T. cutaneum infection of 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.
报道了一名61岁患有皮状毛孢子菌人工瓣膜心内膜炎的男性患者。他在3年前因风湿性心脏病接受了主动脉瓣置换术。瓣膜感染起病呈亚急性。入院时发现有收缩期杂音。随后，他出现结膜出血、血尿以及短暂的意识模糊、失语和颅神经麻痹发作。在3周内采集的17份血培养标本中有3份皮状毛孢子菌呈阳性。给予他两性霉素B（AmB）和5-氟胞嘧啶（5FC）；确诊为人工主动脉瓣皮状毛孢子菌感染。更换了主动脉瓣。术后他出现难治性心室颤动并死亡。体外试验证明AmB-5FC和AmB-利福平联合用药具有显著协同作用。
