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Candida tropicalis endocarditis: Treatment in a resource-poor setting
Prashant Kumar1, Mamta N Muranjan, Milind S Tullu
1Department of Pediatrics, Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, India.
Annals of Pediatric Cardiology
|January 15, 2011
Summary
Fungal endocarditis (FE), rare in children, was diagnosed in a 5-year-old girl with Candida tropicalis. Treatment involved antifungal therapy and valve surgery, leading to recovery.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Mycology
Background:
- Fungal endocarditis (FE) is a rare pediatric condition, typically affecting structurally abnormal hearts.
- Candida species are the most frequent cause of FE in children.
Observation:
- A 5-year-old female presented with fever, cardiac failure, anemia, leukocytosis, and elevated CRP.
- Bacterial cultures were negative, and she did not respond to antimicrobial therapy.
- Echocardiography showed a large mass on the right ventricle and tricuspid valve.
Findings:
- Blood cultures confirmed Candida tropicalis, establishing the diagnosis of FE.
- Treatment included liposomal amphotericin B and surgical excision of the vegetation and tricuspid valve.
- Histopathology and culture of resected tissue confirmed the fungal etiology.
Implications:
- This case highlights the importance of considering fungal infections in pediatric cardiac failure unresponsive to antibiotics.
- Successful management requires a combination of aggressive antifungal therapy and surgical intervention.
- Early diagnosis and multidisciplinary care are crucial for favorable outcomes in pediatric fungal endocarditis.
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