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The third reported case of prosthetic valvular endocarditis caused by the fungus Paecilomyces is presented. The clinical course of the patient is discussed. The distinctive morphology of the fungus is described, together with the histologic and cytologic features found in the excised prosthetic valve and in the tissues at autopsy. Prosthetic valvular endocarditis presents a serious antibiotic and surgical problem in therapy. Despite antifungal antibiotics and valve replacement this patient died as a result of metastatic cerebral microabscesses and subarachnoid hemorrhage.
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