Native-valve endocarditis due to Candida pulcherrima

Abstract

Fungal endocarditis (FE) is an uncommon disease, an while accounting for only 1.3-6% of all cases of infectious endocarditis, it carries a high mortality risk. Usually occurring in intravenous-drug abusers and prosthetic valve recipients, native-valve endocarditis is rarely reported. Fungal endocarditis in commonly complicated by systemic embolization, and the difficulty in isolating the fungi with routine blood cultures complicates the diagnostic process. In these culture-negative cases of endocarditis, etiologic diagnosis is made with histolopathologic examination of the cardiac valve, embolic materials, and systemic ulcers.The fungal endocarditis is considered an absolute indication for valve replacement.Although Candida albicans represents the main etiology of fungal endocarditis, Candida parapsilosis is the most common non-albicans species. The incidence of endocarditis produced by the so-called “opportunists” is progressively increasing in frequency and gradually transforming the clinical picture habitually associated with this disease. We describe a first case of Candida pulcherrima endocarditis involving the aortic valves, with the patient not survived.