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Candida parapsilosis endocarditis: a comparative review of the literature

C Garzoni1, V A Nobre, J Garbino

  • 1Division of Infectious Diseases, University Hospitals of Geneva, 24 Rue Micheli-du-Crest, Geneva 14, Switzerland. Christian.Garzoni@insel.ch

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|September 7, 2007
PubMed

Insights

Fungal endocarditis (FE) due to Candida parapsilosis is rare but deadly. Prosthetic valves and IV drug use are key risks, with high rates of embolic events and mortality, underscoring treatment challenges.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Cardiology

Background:

  • Fungal endocarditis (FE) is a rare but severe condition, accounting for 1.3-6% of infectious endocarditis cases.
  • Candida albicans is the primary cause of FE, but Candida parapsilosis is the most frequent non-albicans species implicated.

Observation:

  • This study reports a case of C. parapsilosis endocarditis in a 32-year-old male with a history of intravenous drug use.
  • A retrospective analysis reviewed 72 cases of C. parapsilosis endocarditis, comparing them with 52 cases of C. albicans endocarditis.

Findings:

  • The most common predisposing factors for C. parapsilosis endocarditis were prosthetic valves (57.4%) and intravenous drug use (20%).
  • Peripheral embolic or hemorrhagic events occurred in 43.8% of patients, frequently affecting the cerebral and lower limb vasculature.
  • The overall mortality rate was 41.7%, with combined surgical and clinical treatment showing a trend towards lower mortality.

Implications:

  • C. parapsilosis endocarditis presents unique clinical features and risk factors compared to C. albicans.
  • Further research is needed to establish optimal treatment strategies, including the role of newer antifungal agents, for C. parapsilosis endocarditis.

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