Cure of Aspergillus ustus Endocarditis on

The almost uniformly fatal outcome ofAspergillusendocarditis, most of which has occurred on prosthetic cardiac valves, has been well documented.1,2The difficulty in the diagnosis of this type of infection, the problems of therapy of prosthetic valve endocarditis, and the relative ineffectiveness of antifungal chemotherapeutic agents account for the high mortality. We describe a patient withAspergillusendocarditis on a prosthetic valve who was cured with a combination of surgery, amphotericin B therapy, and long-term therapy with flucytosine. (This patient was included in a previous report of two patients withAspergillusendocarditis,3but the details and results of therapy were not included in that report.) A review of the literature onAspergillusendocarditis is also included. Patient Summary Patient 1. —A 50-year-old black man was first admitted to the Philadelphia Veterans Administration Hospital in February 1963 because of increasing symptoms of heart failure. He had had rheumatic