Fungal Endocarditis With Severe Vegetations of the Aortic Valve and Septic Emboli Secondary to Total Parenteral Nutrition

Labchuk, Andrii; Hamwi, Mada; Han, Alice; Khan, Muhammad Usman; Stone, Arvey

doi:10.7759/cureus.32357

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…Different factors were found to increase the incidence of nosocomial candidemia, including increased antibiotics use, prolonged fluconazole prophylaxis in immunocompromised patients, use of total parenteral nutrition, and use of long-term catheters and medical devices[ 13 - 16 ]. Additional risk factors include malignancies of the gastrointestinal tract, genitourinary tracts, and the breast associated with CA infection and hematologic malignancy associated with NAC infection.…”

Section: Background and Epidemiologymentioning

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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Section: Background and Epidemiologymentioning

confidence: 99%

Candida endocarditis: Update on management considerations

Jamil,

Akinleye,

Mirzaei

et al. 2023

World J Cardiol

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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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Fungal Endocarditis With Severe Vegetations of the Aortic Valve and Septic Emboli Secondary to Total Parenteral Nutrition

Cited by 2 publications

References 13 publications

Candida endocarditis: Update on management considerations

Candida endocarditis: Update on management considerations

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

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