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Endocarditis III: Medical Management

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Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...

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Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis

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Relapsing Candida parapsilosis Endocarditis With Septic Embolization: A Case Report.

Francisco Teixeira da Silva¹, Francisca S Cardoso², Alexandra Esteves¹

¹Internal Medicine, Unidade Local de Saúde do Alto Minho (ULSAM), Viana do Castelo, PRT.

|March 17, 2021

Summary

Candida endocarditis, a rare but serious fungal infection, poses significant risks, especially for elderly and immunocompromised patients. This case highlights treatment challenges and the poor prognosis associated with invasive Candida parapsilosis prosthetic valve endocarditis.

Keywords:

candida endocarditis candidemia echocardiography - heart failure - valvular heart disease invasive fungal disease valvular endocarditis

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Area of Science:

Infectious Diseases
Cardiology
Mycology

Background:

Candida endocarditis is an emerging, serious infection with high morbidity and mortality, particularly in elderly and immunosuppressed populations.
Treatment dilemmas persist regarding optimal antifungal strategies and duration for Candida endocarditis.

Observation:

A case of Candida parapsilosis prosthetic valve endocarditis with septic embolisms in an elderly male with a biological prosthetic valve.
Clinical presentation included fever, constitutional symptoms, splenic emboli on CT, and a vegetation on transesophageal echocardiography.
The patient had comorbidities precluding surgical intervention and was treated with liposomal amphotericin B, caspofungin, and oral fluconazole.

Findings:

The patient developed lumbar spondylodiscitis and relapsing fungemia with multidrug-resistant Candida isolates.
Despite initial antifungal treatment, the patient experienced a fatal outcome due to sepsis from candidemia and nosocomial urinary sepsis.

Implications:

This case underscores the diagnostic and management complexities of fungal endocarditis.
The poor prognosis and potential for severe complications, including multidrug-resistant infections and sepsis, necessitate careful consideration of treatment approaches.