Native aortic valve endocarditis caused by Candida sake.

Area of Science:

• Infectious Diseases
• Cardiology
• Mycology

Background:

• Native valve endocarditis is a serious infection affecting heart valves without prior damage.
• Candida species, particularly Candida sake, are uncommon causes of endocarditis.
• Risk factors for fungal endocarditis typically include intravenous drug use or prosthetic valves.

Observation:

• A 34-year-old farmer presented with septicemia and multiorgan dysfunction syndrome (MODS).
• Diagnostic work-up revealed severe aortic regurgitation and large vegetations on the aortic valve.
• No history of intravenous drug abuse or pre-existing valvular abnormality was noted.

Findings:

• Infective endocarditis caused by Candida sake was diagnosed.
• The patient required treatment with amphotericin B and subsequent aortic valve replacement surgery.
• Long-term suppressive antifungal therapy was initiated postoperatively.

Implications:

• This case highlights Candida sake as a potential pathogen in native valve endocarditis, even without typical risk factors.
• Aggressive antifungal therapy combined with surgical intervention is crucial for managing such cases.
• Lifelong suppressive antifungal therapy may be necessary for patients with fungal endocarditis to prevent recurrence.