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J Thorac Cardiovasc Surg 2006;131:1181-1183
© 2006 The American Association for Thoracic Surgery

Brief Communication

Fungal prosthetic mitral valve endocarditis caused by Scopulariopsis species: Case report and review of the literature

Alice May B. Isidro, MS a , Valerianna Amorosa, MD b , Gary A. Stopyra, MD c , Harold L. Rutenberg, MD d , William H. Pentz, MD d , Charles R. Bridges, MD, ScD a , *

a Department of Surgery, the University of Pennsylvania Health System, Pennsylvania Hospital, Philadelphia, Pa
b Department of Medicine, Division of Infectious Diseases, University of Pennsylvania Health System, Philadelphia, Pa
c Department of Pathology, Pennsylvania Hospital, Philadelphia, Pa
d Division of Cardiology, Pennsylvania Hospital, Philadelphia, Pa

Received for publication November 17, 2005; revisions received December 22, 2005; accepted for publication December 30, 2005.

* Address for reprints: Charles R. Bridges, MD, ScD, Department of Surgery, the University of Pennsylvania Health System, 4 Silverstein, Hospital of the University of Pennsylvania, Philadelphia, PA 19104 (Email: cbridges@pahosp.com).

The first 20% of the full text of this article appears below.

Scopulariopsis species is a keratinolytic mold with a propensity to cause onychomycosis and rarely to cause deep tissue infection. Scopulariopsis brevicaulis is the most common Scopulariopsis species seen clinically. We review 3 cases of Scopulariopsis species–induced endocarditis in the literature and present a fourth case of Scopulariopsis species–induced prosthetic valve endocarditis.

Clinical Summary

A 67-year-old woman with a past medical history significant for rheumatic fever, gout, pulmonary hypertension, atrial fibrillation, congestive heart failure, and 3 prior valve operations presented with fever and right leg pain. One year before presentation she underwent replacement of her aortic and mitral valves with a 19-mm Carpentier-Edwards Magna pericardial valve and a 25-mm Carpentier-Edwards pericardial valve (Baxter Healthcare Corp, Edwards Lifesciences, Irvine, Calif), respectively. Her social history was significant for pet finches. Her temperature was 101°F, she had a systolic murmur at the left sternal border, and her right foot was cold with diminished pulses. She had no evidence of onychomycosis or peripheral emboli. Abdominal computed tomography demonstrated . . . [Full Text of this Article]




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