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Polymicrobial Pseudomonas Plus Candida Parapsilosis Endocarditis in an Injection Drug User: Considerations for

Maninder Kaur1, Parminder Virdi1, Ramanjit Kaur2

  • 1Internal Medicine, Wayne State University Detroit Medical Center, Detroit, USA.

Cureus
|March 31, 2021
PubMed

Insights

Fungal endocarditis (FE) is a serious infection that is difficult to diagnose, even with positive bacterial cultures. Suspect FE in at-risk patients, as co-infections can occur, complicating diagnosis and treatment.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Mycology

Background:

  • Fungal endocarditis (FE) presents diagnostic challenges due to low blood culture yields.
  • Risk factors for FE include parenteral nutrition, immunosuppression, prior antibiotics, IV drug use, and cardiac surgery.

Observation:

  • This case report details a patient with positive *Pseudomonas* blood cultures.
  • The patient was ultimately diagnosed with *Candida parapsilosis* endocarditis via valve culture.

Findings:

  • Fungal endocarditis can be present even when bacterial pathogens are identified in blood cultures.
  • Co-infection with fungi should be considered in patients with suspected endocarditis and known risk factors.

Implications:

  • Clinicians must maintain a high index of suspicion for fungal endocarditis in at-risk populations.
  • Diagnostic strategies for endocarditis may need to incorporate fungal detection methods.
  • Prompt identification and treatment of fungal endocarditis are crucial for patient outcomes.
Keywords:
cd4 lymphocytopeniafungal endocarditisinjection drug usepseudomonas aeruginosa and candida parapsilosis

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