<i>Candida albicans</i>endocarditis involving a normal native aortic valve in an immunocompetent patient

Sheikh, Taha; Tomcho, Jeremy; Awad, Mohammed; Zaidi, Syeda Ramsha

doi:10.1136/bcr-2020-236902

Cited by 6 publications

(9 citation statements)

References 11 publications

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“…It is imperative to distinguish the difference between commensal and invasive virulent growth; invasion is distinct from superficial colonization as the former is accompanied by inflammatory signals, resulting from the activated immune response. Clinical cases presenting C. albicans infections of the urogenital tract [1][2][3][4][5][6][7][8], kidney [1,7,[9][10][11][12][13], liver [14,15], lungs [16][17][18], spleen [19,20] and even the heart [21][22][23][24][25][26] have been reported. In rare cases, mostly in neonates, C. albicans can traverse the blood-brain barrier, resulting in infections of the brain [27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Amino Acid Sensing and Assimilation by the Fungal Pathogen Candida albicans in the Human Host

Silao

Ljungdahl

2021

Pathogens

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Nutrient uptake is essential for cellular life and the capacity to perceive extracellular nutrients is critical for coordinating their uptake and metabolism. Commensal fungal pathogens, e.g., Candida albicans, have evolved in close association with human hosts and are well-adapted to using diverse nutrients found in discrete host niches. Human cells that cannot synthesize all amino acids require the uptake of the “essential amino acids” to remain viable. Consistently, high levels of amino acids circulate in the blood. Host proteins are rich sources of amino acids but their use depends on proteases to cleave them into smaller peptides and free amino acids. C. albicans responds to extracellular amino acids by pleiotropically enhancing their uptake and derive energy from their catabolism to power opportunistic virulent growth. Studies using Saccharomyces cerevisiae have established paradigms to understand metabolic processes in C. albicans; however, fundamental differences exist. The advent of CRISPR/Cas9-based methods facilitate genetic analysis in C. albicans, and state-of-the-art molecular biological techniques are being applied to directly examine growth requirements in vivo and in situ in infected hosts. The combination of divergent approaches can illuminate the biological roles of individual cellular components. Here we discuss recent findings regarding nutrient sensing with a focus on amino acid uptake and metabolism, processes that underlie the virulence of C. albicans.

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Section: Introductionmentioning

confidence: 99%

Amino Acid Sensing and Assimilation by the Fungal Pathogen Candida albicans in the Human Host

Silao

Ljungdahl

2021

Pathogens

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“…C. parapsilosis is a normal human commensal and is often isolated from the subungual space of human hands [ 3 ]. It has also been isolated from gastrointestinal and genitourinary samples thus indicating its ability to colonize the human body [ 2 , 3 ]. However, invasive disease caused by C. parapsilosis can occur without prior colonization and is often transmitted in a healthcare setting via sources such as medical devices or fluids, the hands of health care workers, prosthetic devices, and catheters [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Candida is an uncommon cause of infective endocarditis (IE) accounting for about 1-2% of all cases of IE but can be associated with a remarkably high mortality rate [ 1 ]. Candida species are normal flora on human skin, the gastrointestinal tract, and the lower genitourinary tract [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Candida usually affects damaged heart valves or hardware, like prosthetic heart valves (2%-10%), pacemakers (4.5%), implantable cardioverter defibrillators, and ventricular assist devices (35%-39%) by forming biofilms [ 2 ]. However native valve endocarditis is seldom reported but may be seen in presence of other concurrent risk factors like immunosuppression, intravenous drug use, neutropenia, diabetes mellitus, chronic indwelling central venous catheters, parenteral nutrition, previous abdominal or cardiac surgery [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Native Valve Candida metapsilosis Endocarditis Following a Ruptured Appendix: A Case Report

Sanku¹,

Youssef²

2022

Cureus

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Candida parapsilosis complex has been further divided into C. parapsilosis , C. orthopsilosis , and C. metapsilosis . C. metapsilosis is considered to be the least virulent fungi of the complex. Candida endocarditis is uncommon but is associated with a very high mortality rate. Prosthetic or previously damaged valves act as common targets, but native, structurally normal valves are seldom affected. We hereby present a case of Candida metapsilosis endocarditis involving a native aortic valve in an immunocompetent 55-year-old male who was successfully treated with surgical valve replacement and antifungal therapy.

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“…In 86 reports, 91 cases of definitive fungal IE were described. These reports involved fifteen cases with Candida parapsilosis [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] , seven cases with C. albicans [55][56][57][58][59][60][61] , three cases with C. tropicalis [62][63][64] , eight other species with Candida [65][66][67][68][69][70][71][72] , eight cases with Candida with a bacterium [73][74][75][76][77][78][79][80] , ten cases with Aspergillus fumigatus [81][82][83][84][85][86][87][88][89]…”

Section: Case Reportsmentioning

confidence: 99%

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

Mistiaen

2024

Vessel Plus

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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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Candida albicansendocarditis involving a normal native aortic valve in an immunocompetent patient

Cited by 6 publications

References 11 publications

Amino Acid Sensing and Assimilation by the Fungal Pathogen Candida albicans in the Human Host

Amino Acid Sensing and Assimilation by the Fungal Pathogen Candida albicans in the Human Host

Native Valve Candida metapsilosis Endocarditis Following a Ruptured Appendix: A Case Report

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

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