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April 23, 1997

Candida albicans Endocarditis With a Contaminated Aortic Valve Allograft—California, 1996

JAMA. 1997;277(16):1271-1272. doi:10.1001/jama.1997.03540400021009

AN ALLOGRAFT heart valve is an implanted valve obtained from a person not related to the recipient. Fungal endocarditis secondary to extrinsic valve contamination is a rare but potentially fatal complication of allograft valve replacement; its incidence following surgery for heart valve replacement with allografts is approximately 0.3%.1,2 Treatment often is unsuccessful, and death is a frequent outcome.3 This report describes the investigation of a case of Candida albicans endocarditis associated with a contaminated aortic valve allograft. The findings indicated that antimicrobial processing of the initial aortic valve allograft did not eliminate C. albicans from the tissue.

In May 1996, a patient in California received an aortic valve allograft (Cryolife, Incorporated, Kennesaw, Georgia*) for aortic insufficiency. No postoperative complications occurred, and 5 days later, the patient was discharged. Eleven days after discharge, the patient was readmitted with fever of 104 F (40 C), nausea, diarrhea,