Contemporary comparison of infective endocarditis caused by Candida albicans and Candida parapsilosis: a cohort study

Jerónimo, Adrián; Olmos, Carmen; Vilacosta, Isidre; Sáez, Carmen; López, Javier; Sanz, Marta; Cabezón, Gonzalo; Pérez-Serrano, Javier; Zulet, Pablo; Román, José Alberto San

doi:10.1007/s10096-022-04456-x

Cited by 3 publications

(4 citation statements)

References 26 publications

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“…Thirty series could be identified. There is a large variation in the rates of fungal IE, which ranges from less than 1% [10][11][12][13][14][15][16] , between 1% and 2% [17][18][19][20][21][22][23][24][25][26][27][28][29] , between 2% and 5% [30][31][32][33][34] , to over 5% [35][36][37][38][39] . The latter series included patients with an immune compromised state such as after transplantation [36] or with prosthetic valves [38,39] .…”

Section: Rate Of Fungal Microorganisms In the Included Series Of Infe...mentioning

confidence: 99%

“…The latter series included patients with an immune compromised state such as after transplantation [36] or with prosthetic valves [38,39] . Most authors group all fungal IE in one category [13,[15][16][17][18][19][20]29,30,32,[34][35][36] ; some only mention Candida ssp [10,15,[22][23][24]28] . or specify the Candida subspecies [11,21,37,39] , or group Candida together with Aspergillus [25] or focus on one specific agent such as Malassezia [33] .…”

Section: Rate Of Fungal Microorganisms In the Included Series Of Infe...mentioning

confidence: 99%

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“Not much room for mushrooms” in the heart: knowns and unknowns of fungal infective endocarditis

Mistiaen

2024

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Fungal infective endocarditis is a rare but highly lethal condition. Its diagnosis is often delayed due to nonspecific symptoms, inconclusive medical imaging, and negative blood cultures. Recent reviews of cases and series over the last 5 years indicate that the condition remains rare and lethal. If fungi are identified as the causative agents in more than 5% of patient cases with infective endocarditis, it is likely that risk factors such as immune suppression or cardiac implants are probably involved. A series derived from recent case reports indicates that Candida and Aspergillus are still the main causative infectious agents, with. C parapsilosis on the rise. From these cases, diagnostic clues (frequent embolisms, ophthalmic involvement, large, mobile and friable vegetation, non-valvular cardiac manifestations) are pointing towards fungal IE. These reports, however, are not standardized and a publication bias towards rare microorganisms or towards a favorable outcome might exist. Complications might be underreported, and important data such as diagnostic delay are absent or difficult to retrieve. Pharmacologic treatment is not fully standardized. Knowledge of resistant strains in this respect is important. Statistical analysis for the effect of complications and treatment modalities on outcome shows that any result should be treated cautiously. The current series is by no means a valid substitute for a well-designed series of fungal endocarditis. However, the better outcome with Candida and patients treated with surgery confirm earlier results. An international multicentric standardized registry of cases with fungal endocarditis in order to improve the outcome of this disease is highly needed. The effect of diagnostic delay on outcome remains elusive and should be resolved.

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Section: Rate Of Fungal Microorganisms In the Included Series Of Infe...mentioning

confidence: 99%

Section: Rate Of Fungal Microorganisms In the Included Series Of Infe...mentioning

confidence: 99%

“Not much room for mushrooms” in the heart: knowns and unknowns of fungal infective endocarditis

Mistiaen

2024

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“…The need for surgical intervention may differ among cases caused by different Candida species. A recent retrospective study showed that surgery was performed earlier in cases of CE caused by Candida parapsilosis compared to CA endocarditis[ 78 ]. Rivoisy et al [ 79 ] demonstrated that in patients with prosthetic valve CE, early surgery was not associated with better survival at six months compared to medical management alone with liposomal amphotericin B induction and long-term suppression with fluconazole.…”

Section: Managementmentioning

confidence: 99%

Candida endocarditis: Update on management considerations

Jamil,

Akinleye,

Mirzaei

et al. 2023

World J Cardiol

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The rise in incidence rates of invasive candidiasis warrants an increase in attention and efforts toward preventing and treating this virulent infection. Cardiac involvement is one of the most feared sequelae and has a poor prognosis. Despite the introduction of several novel antifungal agents over the past quarter century, complications and mortality rates due to Candida endocarditis have remained high. Although fungal endocarditis has a mechanism similar to bacterial endocarditis, no specific diagnostic criteria or algorithm exists to help guide its management. Furthermore, recent data has questioned the current guidelines recommending a combined approach of antifungal agents with surgical valve or indwelling prostheses removal. With the emergence of multidrug-resistant Candida auris , a focus on improved prophylactic measures and management strategies is necessary.

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“…Even though Candida albicans is the most common Candida species causing FE, the non-albicans Candida (NAC) species have also contributed to significant in-hospital mortality and morbidity [5]. Among the NAC species, incidence of C. parapsilosis IEhas increased in the past two decades [2, 6]. Such patients most commonly present with fever and changing or new onset cardiac murmurs [7].…”

Section: Introductionmentioning

confidence: 99%

Prosthetic valve endocarditis due to Candida parapsilosis – a rare case report

Sharma

Samantaray

Kumar

et al. 2023

Access Microbiology

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Fungal endocarditis is a rare and fatal condition, most frequently caused by species of the genera Candida and Aspergillus. Fever and changing heart murmur are the most common clinical manifestations. The diagnosis of fungal endocarditis is challenging, with prosthetic valve endocarditis being extremely difficult to diagnose. The optimal management of the condition still remains debatable. We present a case of prosthetic valve endocarditis caused by Candida parapsilosis, managed empirically with liposomal amphotericin B, which was later shifted to combination therapy with high-dose echinocandin and fluconazole, but had a fatal outcome because the patient could not undergo timely surgical intervention. Treating C. parapsilosis endocarditis cases is difficult because of their biofilm production on native and prosthetic heart valves. A combined approach consisting of a high index of clinical suspicion, early diagnosis using serological markers followed by culture or PCR and prompt initiation of appropriate antifungals may aid in improving outcomes.

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Contemporary comparison of infective endocarditis caused by Candida albicans and Candida parapsilosis: a cohort study

Cited by 3 publications

References 26 publications

“Not much room for mushrooms” in the heart: knowns and unknowns of fungal infective endocarditis

“Not much room for mushrooms” in the heart: knowns and unknowns of fungal infective endocarditis

Candida endocarditis: Update on management considerations

Prosthetic valve endocarditis due to Candida parapsilosis – a rare case report

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