Comparison of Characteristics and Short-Term Outcome From Fungal Infective Endocarditis in Prosthetic Valve Endocarditis Versus Native Valve Endocarditis

Sun, Xiaobo; Zhang, Jiän; Wang, Guogan; Zhuang, Xiao-feng; Yang, Yanmin; Zhu, Jun; Tan, Huiqiong; Yu, Lijiang

doi:10.1016/j.amjcard.2013.02.068

Cited by 17 publications

(4 citation statements)

References 16 publications

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“…Additional treatment with fluconazole was not possible due to the intrinsic resistance of N. glabrata against azoles. It is important to note though, that these recommendations are based on small case studies and expert opinions [ 2 , 3 , 12 , 15 ]. Moreover, it remains unclear whether early surgical intervention is indeed more beneficial as compared to singular IV antifungal therapy [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Nakaseomyces glabrata endocarditis: A therapeutic dilemma

Jim

Daems

Boekholdt

et al. 2023

Medical Mycology Case Reports

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Section: Discussionmentioning

confidence: 99%

Nakaseomyces glabrata endocarditis: A therapeutic dilemma

Jim

Daems

Boekholdt

et al. 2023

Medical Mycology Case Reports

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“…1,[3][4][5][6][7] Investigations comparing the clinical outcomes of medical therapy versus those of combined medical and surgical therapy demonstrated that patients with fungal endocarditis treated with antifungal agents alone tend to have a mortality rate higher than patients treated with a combination of surgery and antifungal agents. 5,[8][9][10][11] Thus, the current guidelines recommend combined medical and surgical therapy for fungal endocarditis. 2,12) However, some recent studies have reported that even in patients who have been treated with combined medical and surgical therapy, the prognosis of CPE is very poor.…”

Section: Discussionmentioning

confidence: 99%

Combined Surgical and Medical Therapy for <i>Candida</i> Prosthetic Endocarditis in a Patient with Repaired Tetralogy of Fallot

et al. 2018

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Candida prosthetic endocarditis (CPE) is an uncommon and fatal complication in adults with congenital heart disease. The current guidelines for the management of fungal endocarditis recommend a combination of surgical and medical therapy. However, it still remains uncertain when surgical management in CPE patients should be performed. Therefore, the prognosis of CPE patients is very poor. Here we report a case of CPE in a 31-year-old woman who had undergone surgical repair for tetralogy of Fallot during childhood and pulmonary valve replacement at the age of 21 years. She underwent re-pulmonary valve replacement after being sufficiently sterilized with a 5-week course of antifungal medical therapy, leading to clinical improvement. In CPE patients, it is necessary to perform surgical therapy while suppressing the activity of fungi as much as possible.

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“…Antifungal monotherapy or sequential therapy combined with surgical approach has been used variably by different institutions [ 1 – 3 , 5 ]. Both patients with FE and CPE tend to have high mortality rate when treated with single or multiple antifungal agents compared to those treated with combination of surgery and antifungal agents [ 1 , 4 , 10 , 20 , 21 ]. Thus current guidelines advise combined medical and surgical treatment for FE who are deemed suitable for surgery [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, the overall relapse which usually happens after stopping oral antifungal suppressive therapy in all types of FE can reach more than 40 % [ 1 , 10 , 21 – 23 ]. Valve tissues have been found to be positive for candida for more than two decades leading to CPE [ 2 , 5 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Recurrent candida prosthetic endocarditis over fifteen years managed with medical therapy and four valvular surgeries: a case report and review of literature

Dhakal

Tribble

Bergin

et al. 2015

J Cardiothorac Surg

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BackgroundCandida prosthetic endocarditis (CPE) is an uncommon disease involving less than 1 % of infective endocarditis patients and associated with high recurrence rate. Immunosuppresion, intravenous drug abuse, cardiac surgery and indwelling foreign bodies are the major risk factors for CPE. There are very few reported cases of CPE where more than one surgery was performed and there has generally been limited follow up on these cases.Case presentationWe report a case of a 35 year old woman who had mitral valve annuloplasty complicated by recurrent episodes of CPE leading to multiple mitral valve replacements (MVR). She underwent MVR surgeries a total of four times over an eighteen year period and had good functionality during most of this time while being on antifungal suppressive treatment. This is a unique case in terms of numbers of surgeries performed, the length of the follow up and the involvement of three different Candida species.ConclusionCurrent guidelines for the treatment of candida endocarditis recommend surgical treatment followed by long term antifungal therapy although the cure rate by all treatments is low. However we feel that based on this one case it is reasonable to consider multiple redo valve replacement surgeries in conjunction with antifungal treatment for selected patients stable enough to tolerate the surgery.

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Comparison of Characteristics and Short-Term Outcome From Fungal Infective Endocarditis in Prosthetic Valve Endocarditis Versus Native Valve Endocarditis

Cited by 17 publications

References 16 publications

Nakaseomyces glabrata endocarditis: A therapeutic dilemma

Nakaseomyces glabrata endocarditis: A therapeutic dilemma

Combined Surgical and Medical Therapy for <i>Candida</i> Prosthetic Endocarditis in a Patient with Repaired Tetralogy of Fallot

Recurrent candida prosthetic endocarditis over fifteen years managed with medical therapy and four valvular surgeries: a case report and review of literature

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