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July 1973

Aspergillus Endocarditis: Therapeutic Failure of Amphotericin B

Author Affiliations

New York

From the Department of Medicine, Bellevue Hospital Center, and the New York University School of Medicine, New York. Dr. Meyer is now with the Department of Microbiology, Navy Medical Research Institute, Bethesda, Md.

Arch Intern Med. 1973;132(1):102-106. doi:10.1001/archinte.1973.03650070088014

Fungal endocarditis is rare, although its reported incidence has been rising coincident with the widespread use of steroids, antibiotics, cytotoxic agents, the advent of cardiac surgery, and increased intravenous heroin addiction.1-3 The genus Aspergillus rarely causes endocarditis.4-9 In two recent reviews, one of 98 patients5 and another of 93 patients6 with aspergillosis, none had endocarditis. Only four cases of Aspergillus endocarditis have been reported in patients who did not have previous cardiac surgery.10-13 Only one case was diagnosed antemortem and the patient treated with a short course of amphotericin B before death.12

We wish to discuss the clinical course of a patient with Aspergillus fumigatus endocarditis who received full therapeutic exposure to amphotericin B. Despite treatment, he succumbed to the embolic complications of the disease. The discussion will concern the management of this rare entity and of fungal endocarditis in general.

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