Fungal endocarditis of native valves

Pipa, Sara; Dias, Cátia; Ribeiro, José; Gregório, Tiago

doi:10.1136/bcr-2018-227202

Cited by 4 publications

(11 citation statements)

References 2 publications

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“…Among them, 28 case series and 15 irrelevant studies were excluded. Finally, 36 case reports encompassing 44 burn patients were included for the final analysis 10–45 …”

Section: Resultsmentioning

confidence: 99%

“…In 36 of the 44 cases, fungal infections were initially suspected and identified from the burn wound samples 10–27,31–33,35–37,39–45 . In the remaining 8 cases, presentations of fungal wound infection were not observed, whereas invasive fungal infections were found in other sites such as blood, arterial thrombosis, teeth, feces, urine, sputum, and tracheal fluid 28–30,34,38 …”

Section: Resultsmentioning

confidence: 99%

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Fungal Infection in Burn Patents

Lineaweaver

Breland

2021

Ann Plast Surg

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Objectives The aims of this study were to review recent fungal infection case reports published, evaluate the treatment regimens and clinical outcomes, and provide recommendations for future management. Methods A review of case reports published over the last decade was conducted. PubMed was searched to collect the relevant citations using a combination of the key words (“burn,” “burned,” “burns,” “fungal,” “fungi,” and “fungus”) in title or abstract. Case series, reviews, guidelines, and experimental and non-English studies were excluded. Statistical analyses were performed using Microsoft Excel 2019. Results A total of 36 case reports encompassing a total of 44 burn patients with fungal infection were included in the final analysis. Ablative surgeries, including surgical excision, debridement, skin graft, vitrectomy, teeth extraction, valve replacement, or amputation, were performed in 38 cases after the suspicion or identification of fungal infection. Twenty-nine of them were eventually discharged, yielding a survival rate of 76.3%. In the remaining 6 cases, ablative surgery was not mentioned and 3 of them eventually died, yielding a survival rate of 50%. The total mortality was 27.27%. Among the 12 death cases, 1 was infected with Candida albicans, 1 with non-albicans Candida, 2 with Aspergillus spp, 2 with Fusarium spp, 4 with Zygomycetes, and 2 with other fungal species. Conclusions The overall mortality of fungal wound infection is still high in burn patients around the world, especially those infected with non-Candida species. Early diagnosis of fungal infection, early initiation of appropriate antifungal therapy, and effective surgical intervention are key measures to improve the treatment effect and reduce the mortality of fungal infection in burn patients.

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“…Among them, 28 case series and 15 irrelevant studies were excluded. Finally, 36 case reports encompassing 44 burn patients were included for the final analysis 10–45 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Fungal Infection in Burn Patents

Lineaweaver

Breland

2021

Ann Plast Surg

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“…Treatment of vaginal candidiasis due to C. glabrata is a challenge to the physician because it usually fails azole therapy. 67 White et al 68 described three patients with recurrent vaginal candidiasis due to C. glabrata who were successfully treated with combination therapy of flucytosine and amphotericin in lubricating jelly. In addition, complicated vaginal candidiasis due to C. glabrata irrespective of boric acid and azole therapy has been successfully managed with topical flucytosine vaginal cream with no or minimal side effects.…”

Section: Clinical Uses Of Flucytosinementioning

confidence: 99%

“…The use of topical 5FC in refractory vaginal candidiasis has been appreciated for two decades. 67 , 68 Although topical flucytosine is not widely available in the market, this option could be extended to other refractory mucocutaneous Candida infections, including those associated with primary immunodeficiency (IL-17 deficiency and chronic mucocutaneous candidiasis) and HIV patients. Clinical trials are necessary.…”

Section: Research Gaps and Future Directionsmentioning

confidence: 99%

Flucytosine and its clinical usage

Sigera

Denning

2023

Therapeutic Advances in Infection

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Flucytosine is an antifungal agent first licensed in the 1970’s. However, its clinical value has long been overlooked and its availability across the globe is limited. This review highlights the important clinical and pharmacological aspects of flucytosine. This a narrative review of the clinical and in vitro susceptibility literature, with a focus on clinical uses for flucytosine. Detailed literature review including early literature related to primary and acquired resistance to flucytosine. Flucytosine has good antifungal activity against Cryptococcus species, Candida species, and dematiaceous fungi. Its water solubility enables good penetration into the eye, urinary tract, central nervous system (CNS), cardiac vegetations and fungal biofilms. In combination with amphotericin B, it shows early fungicidal activity against Cryptococcus species, and this translates to ~20% improved survival in cryptococcal meningitis. Combination therapy also reduces the mortality of Candida meningitis, and should be used in neonatal candidiasis because of the high frequency of CNS infection. Monotherapy for urinary candidiasis is under-studied, but is usually effective. It is probably valuable in the treatment of Candida endocarditis and endophthalmitis: there are few data. It is not effective for aspergillosis or mucormycosis. Flucytosine monotherapy of urinary candidiasis resulted in 22% developing resistance on therapy and failing therapy, and in 29% of 21 patients with cryptococcosis. Certain regions of the world still do not have access to flucytosine compromising the management of certain severe fungal infections. Flucytosine has an important role in combination therapy for yeast and dematiaceous infections and probably as monotherapy for urinary candidiasis, with a modest risk of resistance emergence. Facilitating access to flucytosine in those regions (especially low-income countries) might alleviate the mortality of invasive fungal diseases

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“…Fungal endocarditis is an uncommon disease with a mortality rate of approximately 50%. 1 Valvular vegetations are regularly encountered in fungal endocarditis and frequently embolize to end organs via small and medium-sized arteries; however, an embolus that is large enough to occlude the aorta is rare. 2 In this report we describe a case of multiple emboli caused by aortic valve candidiasis in an immunocompromised patient with acute paraplegia due to an aortic occlusion.…”

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confidence: 99%