Native valve endocarditis due to Candida albicans in two children: Two new case reports

Abstract

Candida endocarditis (CE) is a rare and serious complication of candidemia. Using current diagnostic tools a confirmed diagnosis is often delayed and outcomes remain poor. The majority of new cases occur following cardiac valvular surgery, and/or in patients with the following risk factors: intravenous drug use, cancer chemotherapy, prolonged presence of central venous catheters, and prior history of bacterial endocarditis. It is not a common complication in non‐neutropenic patients particularly with the absence of a prosthetic valve, and very few reports in the literature are available. Attempting to add to the limited data, 211 candidemia episodes from 172 nonneutropenic pediatric cases between January 2008 and December 2017 were evaluated. All patients were considered asymptomatic for underlying heart disease. However, 2 (0.9%) patients with a central venous catheter were determined as having endocarditis following echocardiography.

Giant Right Atrial Abscess in a Premature Infant With Fungal Endocarditis in a Developing Country

“…Although surgical resection of such vegetations in premature babies is considered a high-risk intervention due to low weight and poor general condition of such patients, 7 the adverse mortality rates associated with Candida endocarditis (up to 60% in some reports 4 ) mandate that operative intervention becomes necessary when hemodynamic instability appears. The aims of surgery are relief of obstructive or otherwise hemodynamically adverse consequences of the vegetations (such as valve dysfunction or leaflet destruction) and reducing the risk of endocardial and myocardial invasion and of embolization.…”

“…1 However, cardiac fungal infections can be frequently encountered in preterm infants because of the application of broad-spectrum antibiotics, central venous catheters, and total parenteral nutrition during long-term hospitalization in neonatal intensive care units (NICUs). 2 Despite the improvement in medical treatment of patients with fungal endocarditis, mortality remains high 3 -5 and the decision to surgically treat these patients remains a challenge particularly in low-birth-weight premature newborns. We describe the case of a two-month-old boy with fungal septicemia and a giant right atrial vegetation which was surgically removed as the result of an abscess and hemodynamic compromise, in the Dominican Republic.…”