真菌性(candida glabrata)心内膜炎による三尖弁置換術後,肺化膿症を合併した1例

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  • A CASE REPORT OF LUNG PYOSIS AFTER NATIVE TRICUSPIDAL VALVE REPLACEMENT DUE TO FUNGAL ENDOCARDITIS

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It has been believed that fungal endocarditis is rare in this country, but the number of cases of the disease is increasing. Under a recent background where the operations for cachexic decreased resistance (immune) and these more infectious and severe valve diseases have been increasingly done. However, fungal endocarditis on the tricuspidal valve area in still rare. So far, we have inspected no more than 7 cases of fungal tricuspidal valve endocarditis including this case in Japan.<br> A 66-year-old male with native tricuspidal valve endocarditis associated with acute suppurative cholangitis and pyogenic liver abscess due to Candida glabrata underwent tricuspidal valve replacement with Carpentier-Edwards pericardial bioprosthesis. On the 5th postoperative day bilateral lung pyosis caused by fungal infection developed. Candida glabrata was detected in pus culture from thoracic drains. He died of multiple organ failure 11 days after the operation. The vegetation of fungal endocarditis tends to grow and develop emboli. In this case, it was clear that the reason of postoperative lung pyosis was preoperative lung embolism due to lated surgical operation. We conclude that the principal solution for remedy of fungal endocarditis lies on early diagnosis, early surgical treatment and thorough postoperative chemotherapy.

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