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Fungal endocarditis, 1995-2000
Lígia C Pierrotti1, Larry M Baddour
1Hospital das Clinicas, University de São Paulo, São Paulo, Brazil.
Abstract:
One hundred fifty-two cases of fungal endocarditis (FE) were identified in the English-language literature between January 1, 1995, and June 30, 2000. Although the median age of patients (44 years) was relatively young, injection drug use was identified as a risk factor in only 4.1% of cases. Other factors, including underlying cardiac abnormalities (47.3%), prosthetic valves (44.6%), and central venous catheters (30.4%), were more commonly identified as predisposing conditions and reflect the changing epidemiology of the syndrome. Unfortunately, mortality remains unacceptably high, particularly for patients with Aspergillus-related FE. Novel therapies are needed to improve patient outcomes.
Insights
Fungal endocarditis (FE) cases show a shift in risk factors, with cardiac abnormalities and prosthetic valves more common than injection drug use. High mortality rates, especially for Aspergillus-related FE, highlight the need for new treatment strategies.
Area of Science:
- Infectious Diseases
- Cardiology
- Mycology
Background:
- Fungal endocarditis (FE) is a serious infection affecting heart valves.
- The epidemiology and risk factors for FE have been evolving.
- Previous studies may not fully capture current trends in FE.
Purpose of the Study:
- To analyze the characteristics and outcomes of fungal endocarditis cases.
- To identify the changing risk factors and predisposing conditions for FE.
- To assess the current mortality rates associated with FE.
Main Methods:
- Systematic review of English-language literature.
- Inclusion of cases diagnosed between January 1, 1995, and June 30, 2000.
- Data extraction on patient demographics, risk factors, and outcomes.
Main Results:
- 152 cases of fungal endocarditis were identified.
- The median patient age was 44 years.
- Key risk factors included underlying cardiac abnormalities (47.3%), prosthetic valves (44.6%), and central venous catheters (30.4%).
- Injection drug use was a risk factor in only 4.1% of cases.
- Mortality rates remain high, particularly for Aspergillus-related FE.
Conclusions:
- Fungal endocarditis epidemiology has shifted, with non-injection drug use related factors becoming more prevalent.
- Underlying cardiac conditions and medical devices are significant predisposing factors.
- Improved and novel therapeutic approaches are crucial to reduce the high mortality associated with fungal endocarditis.