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[A case of Candida albicans endocarditis with impaired lung function]
W Yamamoto1, T Ino, I Sakurabayashi
1Jichi Medical School, Omiya Medical Center.
Summary
This case study details a patient with Candida albicans endocarditis who developed a drug reaction to fluconazole. Successful treatment involved valve replacement and managing complications from antifungal therapy.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Mycology
Context:
- A 53-year-old male with a history of pulmonary tuberculosis and respiratory failure presented with persistent fever.
- Initial investigations were inconclusive, but cardiac ultrasonography revealed mitral regurgitation and vegetations.
Purpose:
- To report a case of Candida albicans endocarditis in a patient with significant pre-existing lung disease.
- To highlight the diagnostic and therapeutic challenges, including antifungal resistance and drug-induced complications.
Summary:
- Candida albicans endocarditis was diagnosed despite ineffective initial antimicrobial therapy.
- The patient underwent successful mitral valve replacement but experienced adverse reactions, including eosinophilia and rash, suspected to be from fluconazole.
- A positive lymphocyte stimulating test confirmed fluconazole hypersensitivity.
Impact:
- This case underscores the importance of considering fungal endocarditis in complex patients.
- It emphasizes the need for careful monitoring of antifungal therapy and prompt recognition of adverse drug reactions.