Catastrophic Candida prosthetic valve endocarditis and COVID-19 comorbidity: A rare case

Abstract

Background and Purpose: Coronavirus disease 2019 (COVID-19) and Candida prostatic valve endocarditis present various clinical manifestations which may overlap;hence, discrimination between them is extremely difficult.
 Case report: The case was a 66-year-old man with a past medical history of mitral and aortic valves replacement one year before COVID-19 co-infection. He was admitted with fever (for 7 days), shortness of breath, cough, seizure, lethargy,headache, and 85% oxygen saturation. Transesophageal echocardiography revealed multiple large-sized, highly mobile masses on both sides of the mechanical mitral valve highly suggestive of vegetation. Chest computed tomography scanning showed simulating scattered COVID-19 peripheral ground-glass opacities confirmed by reverse-transcription polymerase chain reaction. The set of blood cultures yielded yeast colonies that were identified as Candida tropicalis. The patient died of septic shock shortly after receiving antifungal therapy.
 Conclusion: This case emphasized the importance of early diagnosis and implementation of antifungal treatment, particularly in patients with prosthetic cardiac valves, to reduce their unfavorable outcomes in COVID-19 patients.

Post‐COVID‐19 fatal Aspergillus endocarditis: A case report

“…9 A study in 2021 suggested that the SARS-CoV-2 virus pandemic has outlined a new problem for the diagnosis of cardiovascular diseases and further care and treatment. 4 A review of endocarditis after COVID-19 showed that the highest percentage of infective endocarditis was related to the mitral valve (33%) of the heart, 8 which is similar to our finding. Patients, who do not have surgery on an infected valve, pose a 100% risk of mortality while in patients who undergo cardiac valve replacement, 45% is reported.…”

“…Over the past year, with the increasing number of patients with COVID‐19, cases of COVID‐19 patients presenting with infective endocarditis have increased 9 . A study in 2021 suggested that the SARS‐CoV‐2 virus pandemic has outlined a new problem for the diagnosis of cardiovascular diseases and further care and treatment 4 …”

“…The most common simultaneity disease found in COVID-19 patients is cardiovascular disease. 4,5 Since the onset of the COVID-19 pandemic, multiple reports of invasive pulmonary aspergillosis have emerged, 6 but COVID-19-associated Aspergillus endocarditis is rare.…”

“…The SARS‐CoV‐2 virus is a novel coronavirus caused by respiratory tract infection with asymptomatic to severe infection presentation. The most common simultaneity disease found in COVID‐19 patients is cardiovascular disease 4,5 . Since the onset of the COVID‐19 pandemic, multiple reports of invasive pulmonary aspergillosis have emerged, 6 but COVID‐19‐associated Aspergillus endocarditis is rare.…”

COVID-19-associated fungal infections in Iran: A systematic review

“…Moreover, a case of endocarditis caused by C . tropicalis was reported in an Iranian patient with prosthetic heart valves, who died despite receiving liposomal amphotericin B [ 20 ]. Another case of endocarditis caused by C .…”