PDF(Pubmed)
Abstract：
We describe a recent case of Coccidioides bioprosthetic aortic valve infective endocarditis successfully managed at our institution. This led us to perform a literature review of endemic fungal infective endocarditis in the United States caused by Coccidioides, Blastomyces, and Histoplasma. Symptoms preceded infective endocarditis diagnosis by several months. Patients with Coccidioides and Blastomyces infective endocarditis were younger with fewer comorbid conditions. Valvular involvement was relatively uncommon in Blastomyces infective endocarditis (27%). Fungemia was noted in patients with infective endocarditis due to Histoplasma (30%) and Coccidioides (18%). Mortality rates for infective endocarditis were high (Histoplasma, 46%; Coccidioides, 58%; Blastomyces, 80%); infective endocarditis was commonly diagnosed post-mortem (Coccidioides, 58%; Blastomyces, 89%). Most surviving patients with infective endocarditis (Histoplasma, 79%; Coccidioides, 80%) underwent valve surgery along with prolonged antifungal therapy. The two surviving patients with Blastomyces infective endocarditis received antifungal therapy without surgery.
摘要：
我们描述了最近在我们机构成功治疗的球虫生物假体主动脉瓣感染性心内膜炎的病例。这导致我们对由球虫引起的美国地方性真菌感染性心内膜炎进行了文献综述，胚芽,和组织支原体。症状先于感染性心内膜炎诊断几个月。球虫和芽孢杆菌感染性心内膜炎患者较年轻，合并疾病较少。在细菌感染性心内膜炎中，瓣膜受累相对罕见（27％）。由于组织胞浆（30％）和球虫（18％）引起的感染性心内膜炎患者出现真菌血症。感染性心内膜炎的死亡率很高(组织胞浆，46%；球虫，58%；胚芽，80%)；通常在死后诊断为感染性心内膜炎(球虫，58%；胚芽，89%）。大多数幸存的感染性心内膜炎患者（组织血浆，79%；球虫，80％）接受了瓣膜手术以及长期的抗真菌治疗。两名幸存的细菌感染性心内膜炎患者接受了抗真菌治疗，而无需手术。
