amphotericin-b and Mitral-Valve-Insufficiency

Systemic infection with Aspergillus fumigatus is an opportunistic disease that affects mainly immunocompromised hosts and is associated with a high mortality rate. We report a case of A. fumigatus endocarditis after an episode of thrombotic thrombocytopenic purpura. Diagnosis was established after sudden rupture of posterior papillary muscle of the normal native mitral valve. Soon after mitral valve replacement, Aspergillus endocarditis recurred, associated with multiple peripheral emboli, which necessitated a second operation.

Topics: Amphotericin B; Anti-Infective Agents; Aspergillosis; Aspergillus fumigatus; Candidiasis; Drug Resistance, Fungal; Embolism; Endocarditis; Fatal Outcome; Female; Heart Valve Prosthesis Implantation; Humans; Immunocompromised Host; Immunosuppressive Agents; Itraconazole; Lung Diseases, Fungal; Middle Aged; Mitral Valve Insufficiency; Opportunistic Infections; Papillary Muscles; Postoperative Complications; Prednisolone; Pseudomonas Infections; Purpura, Thrombotic Thrombocytopenic; Recurrence; Rupture, Spontaneous; Shock, Septic; Sputum; Ultrasonography; Urinary Tract Infections

We present a case of a 2 year old apparently healthy child who presented with fever and mass on the mitral valve. Excision histopathology of the mass revealed mucormycosis. After 4 months, she had CNS embolisation with recurrence of cardiac lesion when investigations revealed associated T-cell immunodeficiency.

Topics: Amphotericin B; Antifungal Agents; Female; Fluconazole; Humans; Immunologic Deficiency Syndromes; Infant; Mitral Valve; Mitral Valve Insufficiency; Mucormycosis; T-Lymphocytes; Ultrasonography

A 54-year-old farmer with moderate mitral valve regurgitation was admitted to hospital because of suspected infective endocarditis.. Echocardiography revealed a large mitral valve vegetation as the source of multifocal septic emboli to the central nervous system, spleen, mesenteric and femoro-popliteal arteries, eyes, and kidneys. Eventually an embolus removed from the femoro-popliteal artery and vegetations on the replaced mitral valve grew C. albicans.. Despite treatment with amphotericin B and valve replacement the patient died of septicemia due to E. coli.. Endocarditis due to C. albicans is commonly associated with severe complications. Diagnosis of this rare disease is often delayed because of negative blood cultures. Large cardiac vegetations and embolization of major arterial vessels should raise the suspicion of fungal endocarditis.

Topics: Amphotericin B; Candida albicans; Candidiasis; Echocardiography; Embolism; Endocarditis; Escherichia coli Infections; Fatal Outcome; Heart Valve Prosthesis; Humans; Male; Middle Aged; Mitral Valve; Mitral Valve Insufficiency; Sepsis

A patient suffering from Candida endocarditis presented with a gangrenous foot. In addition to arterial embolism, occult mycotic aneurysms were found by arteriography. Clinical cure was achieved with a combination of chemotherapy and valvular débridement, but viable Candida persisted in an easily removable embolus. Occult peripheral vascular lesions may be a continuing source of Candida sepsis in some patients.

Topics: Adult; Amphotericin B; Aneurysm, Infected; Aortography; Arterial Occlusive Diseases; Arteritis; Candidiasis; Drug Therapy, Combination; Endocarditis; Female; Flucytosine; Gangrene; Humans; Mitral Valve Insufficiency

Topics: Amphotericin B; Anti-Bacterial Agents; Autopsy; Heart Valve Prosthesis; Humans; Hydrocortisone; Male; Middle Aged; Mitral Valve Insufficiency; Mucormycosis; Prednisolone

Topics: Adult; Amphotericin B; Aortic Valve Insufficiency; Benzene Derivatives; Candidiasis; Endocarditis; Female; Flucytosine; Follow-Up Studies; Heart Septal Defects, Ventricular; Heart Valve Prosthesis; Heroin; Humans; Imidazoles; Male; Mitral Valve Insufficiency; Oxacillin; Pacemaker, Artificial; Radiography, Thoracic; Substance-Related Disorders; Tricuspid Valve Insufficiency