Candida parapsilosis tricuspid native valve endocarditis: 3-year follow-up after surgical treatment

Abstract

In non-addicted patients, several states such as alcoholism, previous valvular heart disease or prosthetic valve replacement, immunodeficiency states, prolonged intravenous hyperalimentation, permanent pacemakers, and some congenital heart diseases can provide the predisposing factors for tricuspid valve endocarditis. It is an extremely rare occurrence in patients with normal native cardiac valves. In this report, we present a case of a 67-year-old woman with tricuspid native valve endocarditis related to Candida parapsilosis which is a very rare cause of infective endocarditis and carries a high mortality risk. An operation was indicated for the patient due to persistent enlarging vegetation on tricuspid valve, severe tricuspid regurgitation, septic pulmonary emboli and finally uncompensated respiratory and heart failure. She underwent tricuspid valve replacement with bioprothesis three years ago and now she is in a satisfactory condition without any medical treatment.

Surgical and Medical Management of Isolated Tricuspid Valve Infective Endocarditis in Intravenous Drug Users

“…We found no overall difference in mortality between early or late surgery confirming that the benefits of surgery at either stage in the disease are not clear. Lastly, the literature supports a combined medical and surgical strategy for fungal endocarditis as outcomes appear better than medical treatment alone . However, it is difficult to justify making this an absolute indication for surgery as there are examples of cases treated successfully without valve replacement, including within the current study.…”

A rare case of Candida parapsilosis endocarditis in a young healthy woman – case report

“…This report presents a rare disease progress in a young and previously healthy person, without any predisposing conditions - no immunodeficiency or previous valve defect [4-6]. In spite of intensive systemic antifungal therapy, which is recommended [2,4,5] there was no improvement, so the operative valve replacement was necessary, which has also been reported in other cases [4-7].…”

“…During the past 20 years, there have been only three cases reported in Sweden [4]. Other authors also refer to Candida endocarditis as an extremely rare occurrence in patients with normal native cardiac valves [6,7]. …”

Candida parapsilosis prosthetic valve endocarditis

“…In the literature, we have found 84 cases of Candida parapsilosis endocarditis. However, only 15 cases were published in the last 10 years [7–19] . The most frequently used treatment was amphotericin B in 55 cases (65%).…”