Torulopsis glabrata endocarditis complicating aortic homograft valve treated with 5-fluorocytosine: case report with discussion of antifungal chemotherapy.

TitleTorulopsis glabrata endocarditis complicating aortic homograft valve treated with 5-fluorocytosine: case report with discussion of antifungal chemotherapy.
Publication TypeJournal Article
Year of Publication1975
AuthorsSharpe DN, Singh BN, Cornere BM, Allwood GK
JournalThe New Zealand medical journal//N Z Med J
Volume81
Issue536
Pagination294 - 8
Date Published1975
ISBN Number0028-8446
Other Numbersobq, 0401067
Keywords*Aortic Valve/tr [Transplantation], *Candida, *Candidiasis/dt [Drug Therapy], *Cytosine/aa [Analogs & Derivatives], *Endocarditis/dt [Drug Therapy], *Flucytosine/tu [Therapeutic Use], *Postoperative Complications/dt [Drug Therapy], Amphotericin B/tu [Therapeutic Use], Aortic Valve Stenosis/su [Surgery], Autopsy, Endocarditis/co [Complications], Endocarditis/pa [Pathology], Humans, Male, Middle Aged, Myocardial Infarction/co [Complications], Myocardial Infarction/pa [Pathology], Myocardium/pa [Pathology], Transplantation, Homologous
Abstract

A case of Torulopsis glabrata endocarditis occurring in a patient 14 months after aortic homograft valve replacement is reported. The infection was not controlled by amphotericin B which led to progressive renal impairment. Re-operation was delayed by the development of multiple infarctions due to coronary emboli. The infection was subsequently eradicated by oral treatment with the newer antifungal agent, 5-fluorocytosine, but death of the patient eventually occurred from an arrhythmia related to the persisting myocardial failure consequent upon episodes of transmural infarction. Current evidence favours the use of early re-operation in all cases of endocarditis in addition to aggressive chemotherapy with a combined regime of amphotericin B and 5-fluorocytosine. Clinical pharmacology of 5-fluorocytosine is briefly discussed.
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