Fungal Endocarditis.

Shi-Min Yuan

doi:10.5935/1678-9741.20160026

Abstract

Fungal endocarditis is a rare and fatal condition. The Candida and Aspergillus species are the two most common etiologic fungi found responsible for fungal endocarditis. Fever and changing heart murmur are the most common clinical manifestations. Some patients may have a fever of unknown origin as the onset symptom. The diagnosis of fungal endocarditis is challenging, and diagnosis of prosthetic valve fungal endocarditis is extremely difficult. The optimum antifungal therapy still remains debatable. Treating Candida endocarditis can be difficult because the Candida species can form biofilms on native and prosthetic heart valves. Combined treatment appears superior to monotherapy. Combination of antifungal therapy and surgical debridement might bring about better prognosis.

Highlights

Fungal endocarditis (FE) remains the most serious form of infective endocarditis, with a high mortality rate of about 50%[1,2]
Candida albicans is responsible for 24-46% of all the cases of FE and for 3.4% of all the cases of prosthetic valve endocarditis, with a mortality rate of 46.6-50%
The affected cardiac sites in neonates significantly differ from those of adults with the right atrium being predominant in 63% of neonates[6]

Summary

INTRODUCTION

Fungal endocarditis (FE) remains the most serious form of infective endocarditis, with a high mortality rate of about 50%[1,2]. It is fatal, usually being diagnosed postmortem[3]. The etiologic fungi more commonly seen are the Candida and Aspergillus species. They can be isolated from surgically removed emboli, resected valves, or infected foreign bodies[4]. After Candida, the Aspergillus species are the second most frequent pathogens of fungal infection, accounting for approximately 25% of all FE cases in cardiac valve prostheses and the great vessels[1]. The affected cardiac sites in neonates significantly differ from those of adults (mitral or aortic valve) with the right atrium being predominant in 63% of neonates[6]

RISK FACTORS

CLINICAL PRESENTATIONS

Findings

CONCLUSION