Relapsing Candida parapsilosis Endocarditis With Septic Embolization: A Case Report

Silva, Francisco Teixeira da; Cardoso, Francisca S; Esteves, Alexandra; Fuente, José M. La; Maia, Rosana

doi:10.7759/cureus.13159

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…The patient presented with persistent fever and symptoms associated with heart failure and pericardial effusion. Unlike bacterial endocarditis, fungal endocarditis is highly associated with embolic and hemorrhagic events (approximately 40-45%) due to the formation of larger vegetations that mainly affect the cerebral area and lower extremities (4,(8)(9)(10) . Fortunately, the patient did not exhibit these complications and was hemodynamically stable upon admission.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of Candida parapsilosis endocarditis of the native tricuspid valve secondary to a tunneled dialysis catheter

Zacarías Mendoza,

Zevallos Goyzueta,

Wu Chen

et al. 2023

Arch Peru Cardiol Cir Cardiovasc

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Candida endocarditis is a severe disease associated with high mortality rates. Candida parapsilosis is frequently identified as the causative pathogen in intravenous drug users and is commonly associated with nosocomial infections, primarily due to its ability to form biofilms on catheters or other foreign bodies. Here, we present a rare case of Candida parapsilosis endocarditis affecting the native tricuspid valve in a 35-year-old male patient with end-stage chronic kidney disease (Stage V), who had a suspected fungal infection related to the left cervical catheter. The patient received treatment with caspofungin and underwent excision of a verrucous tumor on the tricuspid valve. Despite encountering postoperative complications, the patient was discharged on fluconazole treatment and scheduled for follow-up. Candida endocarditis poses a clinical challenge that necessitates a multidisciplinary approach and tailored management due to its infrequent occurrence and higher mortality rate compared to bacterial endocarditis.

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Section: Discussionmentioning

confidence: 99%

An unusual case of Candida parapsilosis endocarditis of the native tricuspid valve secondary to a tunneled dialysis catheter

Zacarías Mendoza,

Zevallos Goyzueta,

Wu Chen

et al. 2023

Arch Peru Cardiol Cir Cardiovasc

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Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management

et al. 2023

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Fungal endocarditis accounts for 1% to 3% of all infective endocarditis cases, is associated with high morbidity and mortality (>70%), and presents numerous challenges during clinical care. Candida spp. are the most common causes of fungal endocarditis, implicated in over 50% of cases, followed by Aspergillus and Histoplasma spp. Important risk factors for fungal endocarditis include prosthetic valves, prior heart surgery, and injection drug use.

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“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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Relapsing Candida parapsilosis Endocarditis With Septic Embolization: A Case Report

Abstract: Teixeira da Silva et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 3 publications

References 21 publications

An unusual case of Candida parapsilosis endocarditis of the native tricuspid valve secondary to a tunneled dialysis catheter

An unusual case of Candida parapsilosis endocarditis of the native tricuspid valve secondary to a tunneled dialysis catheter

Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management

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

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