April 7, 1962

Rhodotorula Fungemia Complicating Staphylococcal Endocarditis

Author Affiliations

Durham, N.C.; Boston

From the Massachusetts Memorial Hospitals, former Assistant Resident in Medicine (Dr. Shelburne) and Junior Physician in Medicine and Assistant in Medicine, Boston University School of Medicine (Dr. Carey). Dr. Shelburne now is Instructor in Medicine, and Fellow, Cardiovascular Disease Service, Duke Hospital, Durham, N.C.; Submitted in honor of Chester S. Keefer, M.D., and the Golden Anniversary of the Evans Memorial Department of Clinical Research, Boston.

JAMA. 1962;180(1):38-42. doi:10.1001/jama.1962.03050140040009

A 56-year-old man with diabetes and staphylococcal endocarditis received intermittent, brief courses of broad-spectrum antibiotics. Fungal superinfection with Rhodotorula resulted. Rhodotorula was cultured repeatedly from the blood and urine during a period of high fever, while the patient was on adequate antibiotic therapy for staphylococcus. During and after treatment with amphotericin B and massive doses of penicillin, repeated blood cultures were sterile, and the patient recovered from this infection and superinfection. Amphotericin B was given intravenously in gradually increasing amounts until a daily dosage of 1.0 mg. per kilogram was achieved for 3 weeks. One can only speculate whether the fungus actually invaded the heart valves, but therapy was continued for this period because of this possibility. Fourteen months after discharge from the hospital, the patient was well except for a residual right hemiparesis.