McClellan J R, Hamilton J D, Alexander J A, Wolfe W G, Reed J B
J Thorac Cardiovasc Surg. 1976 Mar;71(3):472-5.
Fungal endocarditis following prosthetic valve surgery has assumed increased importance as a cause of postoperative death. We present, to our knowledge, the first case of the fungus Paecilomyces varioti producing endocarditis on a prosthetic aortic valve. This seems to be an extremely indolent organism which exhibits an apparent response to antibiotic therapyl. In vitro evidence suggests that this fungus is sensitive to attainable serum levels of both 5-fluorocytosine and amphotericin B. However, after viewing the extracted valve and the devastating embolic phenomenon in our patient, we believe that medical therapy alone would not suffice. Thus we suggest that prompt valve replacement be performed in future cases.
人工瓣膜置换术后发生的真菌性心内膜炎作为术后死亡原因，其重要性日益增加。据我们所知，我们报告了首例由拟青霉菌引起的人工主动脉瓣心内膜炎病例。这似乎是一种极其惰性的微生物，对抗生素治疗有明显反应。体外证据表明，这种真菌对可达到的血清水平的5-氟胞嘧啶和两性霉素B均敏感。然而，在观察了我们患者取出的瓣膜和严重的栓塞现象后，我们认为仅靠药物治疗是不够的。因此，我们建议在未来的病例中应及时进行瓣膜置换。
