Trichosporon inkin Endocarditis: Short-Term Evolution and Clinical Report

• Published in: Clinical infectious diseases Vol. 23; no. 2; pp. 396 - 397
• Main Authors: Chaumentin, G., Boibieux, A., Piens, M. A., Douchet, C., Buttard, P., Bertrand, J. L., Peyramond, D.
• Format: Journal Article
• Language: English
• Published: Chicago, IL University of Chicago Press 01.08.1996
• Subjects: Antibodies; Biological and medical sciences; Blood; Brief Reports; Endocarditis; Endocarditis - drug therapy; Endocarditis - microbiology; Endocarditis - physiopathology; Eosinophils; Fever; Heart valves; Human mycoses; Humans; Infectious diseases; Lower extremity; Medical sciences; Middle Aged; Miscellaneous mycoses; Mycoses; Mycoses - drug therapy; Mycoses - microbiology; Mycoses - physiopathology; Trichosporon; Trichosporon - isolation & purification; Trichosporon inkin; Vegetation; Human; Mycosis; Cardiovascular disease; Fungi; Infection; Case study; Heart disease; Endocardial disease; Endocarditis; Female; Fungi Imperfecti; Thallophyta; Trichosporon
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1093/clinids/23.2.396

We report a case of T. inkin endocarditis in a 46-year-old woman who presented with fever, cutaneous signs, and embolic manifestations nearly 4 years after a mitral valve replacement. Only nine cases of trichosporon endocarditis have been described to our knowledge, and this case report is believed to be the tenth--but it is the first one concerning T. inkin. A 46-year-old woman was admitted to our infectious diseases unit in September 1994 because of the recent onset of arthralgia, myalgia, fever, chills and sweats, and cutaneous manifestations (petechiae) on the lower limbs. She had undergone prosthetic mitral valve replacement for rheumatic valvular disease in 1991. The clinical onset of symptoms began 2 weeks before admission, with recurrence of pharyngitis; this was treated with methylprednisolone and cefpodoxime proxetil. A successful mitral valve replacement and left femoral embolectomy were performed on day 8. T. inkin was identified in both the valvular vegetation and the embolic material by cultures (in which septate hyphae with arthrospores and yeasts were noted) and by immunologic tests, which were positive for T. inkin--specific antibodies but negative for antibodies to T. mucoides and T. asahii. As soon as a mycologic diagnosis was established, three different blood samples were tested (over 1 month); antibodies to T. inkin were detected by agglutination and precipitation tests (double-diffusion and counter-electrophoresis precipitation techniques were used with strains isolated from valvular and embolic material and with the T. inkin reference strain number 15, from Institut Pasteur, Paris).