CASI CLINICI   

Chirurgia 2015 February;28(1):23-5

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Inglese

Pacemaker-related endocarditis caused by Microascus trigonosporus: a case report and review of literature

Ge Y. ¹, Wang P. ², Xu Y. ², Miao Q. ³, Yu H. ⁴, Liu Z. ¹, Li T. ¹

¹ Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; ² Department of Clinical Laboratory, Peking Union Medical College Hospital Chinese Academy of Medical Sciences, Beijing, China; ³ Department of Cardiac Surgery, Peking Union Medical College Hospital Chinese Academy of Medical Sciences, Beijing, China; ⁴ Peking Union Medical College and Tsinghua University, Beijing, China

AIM: Endocarditis caused by Microascus trigonosporus is rarely reported. Here we report a case of a 46-year-old man with endocarditis caused by M. trigonosporus after cardiac pacemaker implantation.
METHODS: This strain of Microascus trigonosporus was isolated from the pacemaker surface. Histopathology sections from the biopsied vegetations lesion demonstrated abundant septate hyphae and intercalary swollen chlamydospores was consistent with a fungal etiology. This paper studied the Microascus trigonosporus characteristic and ITS region was amplified and sequenced. Antifungal drugs susceptibility test was also performed in vitro.
RESULTS: The Etest result showed that MIC of itraconazole is ≥32 µg/mL, amphotericin B is ≥32 µg/mL, however voriconazole is 4 µg/mL. Vegetations were removed by surgical debridement and voriconazole was used. After that, the patient recovered with the normal temperature in a short time and resulted in a favorable outcome.
CONCLUSION: With the rising incidence of fungi infections, clinicians should be aware of the opportunistic infections caused by Microascus and remain alert.