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Incidence and outcome of documented fungal endocarditis

Parisa Badiee1, Ahmad Ali Amirghofran2, Mohammad Ghazi Nour2

  • 1Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.

International Cardiovascular Research Journal
|January 24, 2015
PubMed
Abstract

Insights

Fungal endocarditis, a severe heart infection, requires consideration in patients unresponsive to antibiotics. Molecular diagnostics and susceptibility testing are key to improving management of this condition.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Mycology

Background:

  • Fungal endocarditis is a severe form of infective endocarditis with high mortality and morbidity.
  • It often presents in patients unresponsive to standard antibacterial therapies.

Purpose of the Study:

  • To analyze the characteristics of fungal endocarditis.
  • To improve the clinical management of patients diagnosed with fungal endocarditis.

Main Methods:

  • Cross-sectional study of surgically removed vegetations and embolic material from patients with suspected infective endocarditis.
  • Direct smear, culture, and antifungal susceptibility testing of isolated fungal species.
  • Real-time PCR performed on blood and tissue samples.

Main Results:

  • Fungal endocarditis was confirmed in 11 out of 31 patients not responding to antibacterial therapy.
  • Predisposing factors included previous surgery and drug abuse.
  • Aspergillus spp. and Candida albicans were the most common isolates, with observed resistance to specific antifungal agents (amphotericin B, itraconazole, fluconazole).
  • Positive PCR results were detected in both blood and tissue samples.

Conclusions:

  • Fungal endocarditis must be suspected in patients with infective endocarditis refractory to antimicrobial treatment.
  • Molecular diagnostic methods and antifungal susceptibility profiling are crucial for optimizing patient management.
Keywords:
AspergillusCandidaEndocarditisFungus Susceptibility

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