Bryan C S, Smith C W, Berg D E, Karp R B
Department of Medicine, University of South Carolina School of Medicine, Columbia.
Clin Infect Dis. 1993 Jan;16(1):30-2. doi: 10.1093/clinids/16.1.30.
A 44-year-old man developed endocarditis due to Curvularia lunata on a Carpentier-Edwards porcine heterograft with clinical involvement of the ring of the aortic valve and the aortic root. Because curative surgery was considered to be extremely high risk, he was treated with antifungal drugs for nearly 7 years. Initial treatment with amphotericin B and ketoconazole was followed by long-term treatment with terbinafine, an experimental allyamine derivative. No adverse effects were attributed to terbinafine. At surgery nearly 7 years later, the aortic valve ring and aortic root appeared to be uninvolved, and the valve was replaced uneventfully. To our knowledge, this is the first report of successful treatment of curvularia endocarditis.
一名44岁男性在植入Carpentier-Edwards猪异种移植人工心脏瓣膜后,因新月弯孢霉感染发生心内膜炎,临床累及主动脉瓣环和主动脉根部。由于根治性手术被认为风险极高,他接受了近7年的抗真菌药物治疗。最初使用两性霉素B和酮康唑治疗,随后长期使用特比萘芬(一种实验性烯丙胺衍生物)治疗。未发现特比萘芬有不良反应。近7年后进行手术时,主动脉瓣环和主动脉根部似乎未受影响,瓣膜顺利置换。据我们所知,这是首例成功治疗弯孢霉心内膜炎的报告。