ABSTRACT
A 35-year-old man with a history of intravenous drug use developed endocarditis due to Rothia dentocariosa that was complicated by a perivalvular abscess. Despite combined medical and surgical treatment, abscess formation progressed following aortic valve replacement, and the patient died during a second operative procedure. This is the sixth case of Rothia dentocariosa endocarditis reported in the English-language literature, and to our knowledge, the only case in which a perivalvular abscess has been documented.
Subject(s)
Abscess/complications , Actinomycetaceae/isolation & purification , Actinomycetales Infections , Aortic Valve , Endocarditis, Bacterial/complications , Abscess/diagnostic imaging , Abscess/drug therapy , Abscess/surgery , Actinomycetales Infections/diagnostic imaging , Actinomycetales Infections/drug therapy , Actinomycetales Infections/surgery , Adult , Aortic Valve/surgery , Bioprosthesis , Echocardiography , Endocarditis, Bacterial/diagnostic imaging , Endocarditis, Bacterial/drug therapy , Endocarditis, Bacterial/surgery , Gentamicins/therapeutic use , Heart Valve Diseases/complications , Heart Valve Diseases/diagnostic imaging , Heart Valve Diseases/drug therapy , Heart Valve Diseases/surgery , Heart Valve Prosthesis , Humans , Male , Postoperative Complications , Staphylococcus epidermidis/isolation & purification , Substance Abuse, Intravenous/complications , Vancomycin/therapeutic useABSTRACT
Phaeohyphomycosis caused by Exophiala species is an unusual infection, but it has been reported with increasing frequency as immunosuppressive therapy has become more widespread and laboratory methods for diagnosis have improved. To our knowledge, the first case of subcutaneous phaeohyphomycosis due to Exophiala jeanselmei in a cardiac transplant patient is presented, and previously reported cases of exophiala infection are reviewed. This patient was successfully managed with surgical excision of the lesion and combination therapy with amphotericin B and 5-fluorocytosine.
