Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Apr 15;61(8):1279-1283.
doi: 10.2169/internalmedicine.7536-21. Epub 2021 Sep 25.

Non-valvular Infective Endocarditis Caused by Sarocladium kiliense in an Immunocompromised Patient with Aplastic Anemia

Hiroaki Kitamura  1 , Yasushi Kubota  2 , Rika Tomimasu  1 , Michiaki Akashi  3 , Tadashi Mori  4 , Yutaro Mine  5 , Jun Ando  6 , Somay Yamagata Murayama  7 , Shinya Kimura  2 , Masaharu Miyahara  1
Affiliations
Case Reports

Non-valvular Infective Endocarditis Caused by Sarocladium kiliense in an Immunocompromised Patient with Aplastic Anemia

Hiroaki Kitamura et al. Intern Med. .

Abstract

Sarocladium kiliense is ubiquitous in the human environment and is an emerging opportunistic pathogen, especially among immunocompromised hosts. A 77-year-old man diagnosed with aplastic anemia suffered from non-valvular endocarditis. After he passed away, fungal hyphae were observed in several lesions on a postmortem examination. Polymerase chain reaction (PCR) and a DNA sequence analysis revealed S. kiliense as the causative organism. This is the first case report of non-valvular fungal endocarditis caused by S. kiliense identified by PCR and a DNA sequence analysis in an immunocompromised patient. Although rare, invasive fungal infection caused by S. kiliense should be considered in immunocompromised hosts.

Keywords: Sarocladium kiliense; aplastic anemia; immunocompromised host; infective endocarditis; non-valvular vegetation.

PubMed Disclaimer

Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
Contrast computed tomography findings. A, B: Chest computed tomography shows consolidations in the apex of the left lung and the right middle lung (arrows). C, D: Abdominal computed tomography shows low-density lesions in the spleen and non-enhancing lesions in the right kidney (arrows).
Figure 2.
Figure 2.
A transthoracic echocardiogram taken using a four-chamber view shows a vegetation (arrow) attached to the basal interventricular septum. LA: left atrium, LV: left ventricle, MV: mitral valve, RA: right atrium, RV: right ventricle
Figure 3.
Figure 3.
Clinical course after the first visit to our hospital. ABPC/SBT: ampicillin/sulbactam, AMPC/CVA: amoxicillin/clavulanic acid, ATG: anti-thymocyte globulin, CRP: C-reactive protein, CsA: cyclosporine, EPAG: eltrombopag, ITCZ: itraconazole, LVFX: levofloxacin, VCM: vancomycin, VRCZ: voriconazole, WBC: white blood cell
Figure 4.
Figure 4.
Findings of a Sarocladium kiliense vegetation at autopsy. A: A vegetation attached to the left ventricular wall (arrow). B, C: Grocott’s methenamine silver stain of the vegetation. D-F: Scanning electron microscopy photographs of the vegetation.
See this image and copyright information in PMC

References

    1. Pierrotti LC, Baddour LM. Fungal endocarditis, 1995-2000. Chest 122: 302-310, 2002. - PubMed
    1. Ammannaya GKK, Sripad N. Fungal endocarditis: what do we know in 2019? Kardiol Pol 77: 670-673, 2019. - PubMed
    1. Pasha AK, Lee JZ, Low SW, Desai H, Lee KS, Al Mohajer M. Fungal endocarditis: update on diagnosis and management. Am J Med 129: 1037-1043, 2016. - PubMed
    1. Guarro J, Gams W, Pujol I, Gene J. Acremonium species: new emerging fungal opportunists - in vitro antifungal susceptibilities and review. Clin Infect Dis 25: 1222-1229, 1997. - PubMed
    1. Summerbell RC, Gueidan C, Schroers HJ, et al. Acremonium phylogenetic overview and revision of Gliomastix, Sarocladium, and Trichothecium. Stud Mycol 68: 139-162, 2011. - PMC - PubMed

Publication types

Supplementary concepts