Native Valve Candida metapsilosis Endocarditis Following a Ruptured Appendix: A Case Report

Sanku, Koushik; Youssef, Dima

doi:10.7759/cureus.21178

Cited by 1 publication

(6 citation statements)

References 7 publications

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“…This could be the reason for the surprisingly low mortality rate of the current case series, particularly those with prosthetic valve endocarditis (PVE) [1,53,58,80,89,103,107] . However, in line with prior observations, Candida species, with a reported 40%-60% rate [44,52,57,60,69,62,94,96,123,126] , is the most frequently reported infectious agent in the current case series.…”

Section: Discussionsupporting

confidence: 89%

“…In 86 reports, 91 cases of definitive fungal IE were described. These reports involved fifteen cases with Candida parapsilosis [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] , seven cases with C. albicans [55][56][57][58][59][60][61] , three cases with C. tropicalis [62][63][64] , eight other species with Candida [65][66][67][68][69][70][71][72] , eight cases with Candida with a bacterium [73][74][75][76][77][78][79][80] , ten cases with Aspergillus fumigatus [81][82][83][84][85][86][87][88][89]…”

Section: Case Reportsmentioning

confidence: 99%

“…Most of the cases underwent computer tomographic (CT) imaging and MRI of the brain, thorax, abdomen, and pelvis, as well as CT-angiography, encompassing almost all infective species involved. A positron emission tomography or PET/CT scan was performed in order to confirm or exclude other septic foci for various fungal species such as Candida [50,60,69,80] , Aspergillus [96,97] , and other infective agents [104,119] . and delay of diagnosis of > 30 days showed no significant effect.…”

Section: Case Reportsmentioning

confidence: 99%

“…PET/CT is of less value in patients with native valve IE because of low sensitivity [38,129] . A PET/CT scan can be needed to detect fungal dissemination [16,69,114,119] or local extension of the infection [80,96] .…”

Section: Echocardiographic Evaluation Of Fungal Iementioning

confidence: 99%

“…A cardiac CT can be needed to demonstrate the vegetation or filling defect [123] or cardiac abscesses [85] . Cardiac MRI can sometimes be necessary for the distinction between invasive aspergilloma and a tumor of the heart [69,98,99] . CT/MRI of other regions is part of the work-up, especially in cases of stroke or infarctions and abscesses of other solid organs.…”

Section: Other Imaging Modalities In Fungal Iementioning

confidence: 99%

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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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