Successful medical treatment of Candida endocarditis with liposomal amphotericin B without surgical intervention

Stripeli, Fotini; Tsolia, Mariza; Trapali, Ch; Papaevangelou, Vasiliki; Vlachos, Eugenios; Pasparakis, D.; Constantopoulos, A

doi:10.1007/s00431-007-0498-8

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…Two cases of infants (2 and 3 months of age) with endocarditis after congenital heart surgery were presented by Stripeli et al [ 13 ] . Both patients received AMB treatment without surgical intervention.…”

Section: Resultsmentioning

confidence: 99%

“…Surgical intervention is considered the gold standard in addition to pharmacological therapy [ 12 ] , but in some cases a good response has been achieved only with drug therapy, especially AMB [ 9 , 13 ] . These cases include patients with minor vegetations found and high risk of perioperative death, whose pharmacological therapy should be first-line treatment [ 14 , 15 ] .…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, among patients without surgical intervention, the history of relapses was not observed [ 15 ] . Therefore, antifungal monotherapy with AMB may be considered, especially in critically ill patients in whom surgery is not a viable option [ 13 ] .…”

Section: Introductionmentioning

confidence: 99%

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Antifungal Efficacy of Amphotericin B in Candida Albicans Endocarditis Therapy: Systematic Review

Bezerra

Silva

Santos-Veloso

et al. 2020

Braz J Cardiovasc Surg

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Introduction Although it is the most common agent among the fungal causes of endocarditis, Candida albicans endocarditis is rare. Objective To evaluate the efficacy of amphotericin B in the treatment of C. albicans endocarditis beyond a systematic review. Data search Articles in English, Spanish and Portuguese, conducted in the following databases: MEDLINE, LILACS, IBECS and SciELO, in humans and published in the last 25 years. Study selection Observational studies, clinical trials, and case series providing data on the amphotericin B use in patients with a C. albicans endocarditis diagnosis without age limitations. Data synthesis From the initial search (n=79), 25 articles were fully evaluated, of which 19 were excluded for meeting one or more exclusion criteria, remaining five articles (two observational studies and three case series). Patients using amphotericin B demonstrated improvement in survival rates, and its main use was in association with the surgical method as well as with caspofungin association. Conclusion Literature lacks evidence to conclude about efficacy and safety of amphotericin B in the treatment of fungal endocarditis. Randomized clinical trials are necessary to provide better evidence on the subject.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Antifungal Efficacy of Amphotericin B in Candida Albicans Endocarditis Therapy: Systematic Review

Bezerra

Silva

Santos-Veloso

et al. 2020

Braz J Cardiovasc Surg

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“…Anecdotal reports document successful medical treatment of FE,[8–11] but most often, as in this case, combined approach with both antifungal therapy and radical surgery offers survival advantage and is recommended. [1212] Amphotericin B is the drug of choice for treatment.…”

Section: Discussionmentioning

confidence: 99%

Candida tropicalis endocarditis: Treatment in a resource-poor setting

et al. 2010

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Fungal endocarditis (FE) is rare in children and does not usually occur in structurally normal hearts. The commonest causative agent is Candida albicans. We report a 5-year-old female child presenting with high-grade fever and cardiac failure. Anemia, leukocytosis and high CRP were found, but bacterial blood culture was sterile. There was no response to antimicrobial agents. Two-dimensional echocardiography revealed a large heterogeneous mass attached to the right ventricle and tricuspid valve. Provisional diagnosis of FE was made, which was confirmed by growth of Candida tropicalis in blood culture. Liposomal amphotericin B was started, followed by radical curative surgery including excision of the entire vegetation with total tricuspid valve excision. Histopathology and culture of the resected vegetation confirmed the diagnosis. The patient was given antifungal therapy for a total of 7 weeks, including 2 weeks of post-operative treatment, following which she was afebrile.

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“…IDSA guidelines recommend echinocandins with or without fluconazole as first-line therapy, which was found to be non-inferior to amphotericin B in managing endocarditis[ 8 , 69 ]. Additional challenges are encountered with NAC species, such as Candida lusitaniae and Candida krusei , which are intrinsically resistant to polyenes and fluconazole, respectively[ 72 , 73 ].…”

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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Successful medical treatment of Candida endocarditis with liposomal amphotericin B without surgical intervention

Cited by 7 publications

References 8 publications

Antifungal Efficacy of Amphotericin B in Candida Albicans Endocarditis Therapy: Systematic Review

Antifungal Efficacy of Amphotericin B in Candida Albicans Endocarditis Therapy: Systematic Review

Candida tropicalis endocarditis: Treatment in a resource-poor setting

Candida endocarditis: Update on management considerations

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