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  • Title: Torulopsis glabrata endocarditis complicating aortic homograft valve treated with 5-fluorocytosine: case report with discussion of antifungal chemotherapy.
    Author: Sharpe DN, Singh BN, Cornere BM, Allwood GK.
    Journal: N Z Med J; 1975 Mar 26; 81(536):294-8. PubMed ID: 1055952.
    Abstract:
    A case of Torulopsis glabrata endocarditis occurring in a patient 14 months after aortic homograft valve replacement is reported. The infection was not controlled by amphotericin B which led to progressive renal impairment. Re-operation was delayed by the development of multiple infarctions due to coronary emboli. The infection was subsequently eradicated by oral treatment with the newer antifungal agent, 5-fluorocytosine, but death of the patient eventually occurred from an arrhythmia related to the persisting myocardial failure consequent upon episodes of transmural infarction. Current evidence favours the use of early re-operation in all cases of endocarditis in addition to aggressive chemotherapy with a combined regime of amphotericin B and 5-fluorocytosine. Clinical pharmacology of 5-fluorocytosine is briefly discussed.
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