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Arthritis and Endocarditis from Exophiala jeanselmei Infection

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Centro de Educacion Medica e Investigaciones Clinicas "Norberto Quirno"; Buenos Aires, Argentina

Ann Intern Med. 1988;108(5):773. doi:10.7326/0003-4819-108-5-773_1
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To the editor: Phialophora species cause endocarditis (1) and arthritis (2). We report a case of chronic arthritis and endocarditis due to Exophiala jeanselmei (formerly Phialophora jeanselmei).

A 50-year-old man had surgery for a ventricular septal defect. In June 1980, he had osteoarthritis of the right knee. Steroids were injected intraarticulary. In 1981 and 1982, cultures of synovial fluid were sterile, and specimens from two synovial biopsies showed chronic inflammation. In September 1982, he had surgery for fever of unknown origin and pulmonary emboli. E. jeanselmei was isolated from the prosthetic patch. Antibodies against mycelial stage antigen were detected. The


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