Document Detail

Truffle's revenge: a pig-eating fungus.
MedLine Citation:
PMID:  18402787     Owner:  NLM     Status:  MEDLINE    
A 77-year-old female initially presented with symptomatic mitral valve stenosis involving a bioprosthesis that had been implanted 8 months earlier for myxomatous mitral valve disease and severe valvular regurgitation. The patient was taken for a second mitral valve replacement due to stenosis. Intraoperatively, the bioprosthetic mitral valve was noted to have an unusual clot-like mass on the atrial side. Initial fungal smears were positive for yeast stains, and pathology revealed extensive colonization by thick filamentous fungus with apparent true hyphae, pseudohyphae, and yeast forms. The fungus was identified as Hormographiella aspergillata, the asexual form of Coprinus cinereus, a common inky cap mushroom that grows in the lawn. She was treated with 6 weeks of liposomal amphotericin B and then switched to voriconazole for long-term (lifelong) suppressive therapy in the setting of a new mechanical mitral valve. The only other reported case of infective endocarditis caused by a Coprinus species occurred in a 53-year-old man who had developed native aortic valve fungal endocarditis and died [J Med Microbiol (1971);4(3):370-4]. The valve isolate was identified as probable C. cinereus.
Erin L Greer; Todd J Kowalski; Monica L Cole; Dylan V Miller; Larry M Baddour
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-06-20
Journal Detail:
Title:  Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology     Volume:  17     ISSN:  1054-8807     ISO Abbreviation:  Cardiovasc. Pathol.     Publication Date:    2008 Sep-Oct
Date Detail:
Created Date:  2008-09-08     Completed Date:  2008-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9212060     Medline TA:  Cardiovasc Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  342-3     Citation Subset:  IM    
Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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MeSH Terms
Amphotericin B / therapeutic use
Antifungal Agents / therapeutic use
Bioprosthesis / adverse effects*
Dyslipidemias / complications
Endocarditis / microbiology*,  pathology,  physiopathology
Gastroesophageal Reflux / complications
Heart Valve Prosthesis / adverse effects*
Hypertension / complications
Mitral Valve Stenosis / complications,  surgery
Mycoses / microbiology*,  pathology,  physiopathology
Prosthesis-Related Infections / microbiology*,  pathology,  physiopathology
Pyrimidines / therapeutic use*
Triazoles / therapeutic use*
Reg. No./Substance:
0/Antifungal Agents; 0/Pyrimidines; 0/Triazoles; 0/liposomal amphotericin B; 0/voriconazole; 1397-89-3/Amphotericin B

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