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Candidal endocarditis presenting with bilateral lower limb ischemia
1Armstrong Atlantic State University, Department of Medical Technology, 11935 Abercorn St., Savannah, GA, USA.
Summary
Fungal endocarditis, often caused by Candida species, is rising. This case highlights a rare presentation of Candida albicans infection causing limb ischemia, emphasizing diagnosis and treatment challenges.
Area of Science:
- Cardiology
- Infectious Diseases
- Mycology
Background:
- Fungal endocarditis incidence is increasing, particularly Candida species infections.
- It is associated with underlying heart disease and presents diagnostic challenges due to negative blood cultures.
- Complications include cardiac damage, inflammation, emboli, ischemia, and tissue death.
Observation:
- A 41-year-old female presented with acute lower extremity pain, numbness, and tingling.
- She had a history of culture-negative endocarditis and valve replacement.
- Limb-threatening ischemia necessitated bilateral thrombectomy, revealing Candida albicans debris.
Findings:
- Transesophageal echocardiogram identified a pedunculated mass, the source of Candida albicans infection.
- The patient was treated with micafungin and voriconazole.
- Diagnosis: Candida albicans fungal infection with a descending aorta fungal mass.
Implications:
- This case underscores the importance of considering fungal endocarditis in atypical presentations.
- It highlights diagnostic difficulties and the need for prompt surgical and antifungal treatment.
- Illustrates an unusual presentation of candidal endocarditis, informing disease epidemiology, pathogenesis, diagnosis, and treatment strategies.
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