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Published on: September 20, 2018
Fungal Endocarditis: A Case Report
Margarida Brito Monteiro1, Rita Sismeiro1, Catarina Negrão1
1Internal Medicine, Hospital Prof. Doutor Fernando Fonseca, Amadora, PRT.
Abstract:
Fungal endocarditis is a rare disease, and it is associated with severe complications and poor prognosis despite combined clinical and surgical treatment. Although Candida albicans (C. albicans) is the most common etiological agent of this severe form of endocarditis, Candida parapsilosis (C. parapsilosis) is the most common non-albicans causative species. It occurs mostly in patients with predisposing risk factors, and the rarity of this disease demands a high index of suspicion; the diagnosis must be vigilantly pursued by echocardiography and multiple blood cultures. The past few decades have witnessed a rise in the incidence of this disease, mainly due to improvements in the diagnostic approach. We report the case of a 63-year-old man with no previous medical history of cardiac disease and no risk factors who was diagnosed with fungal endocarditis due to C. parapsilosis without fungemia. This report illustrates a rare case of fungal endocarditis in a patient with no risk factors and highlights the challenges encountered in the diagnosis, along with complications and predictors of poor prognosis.
Insights
Fungal endocarditis caused by Candida parapsilosis is rare, especially without fungemia in patients without risk factors. This case highlights diagnostic challenges and poor prognosis predictors for this uncommon infection.
Area of Science:
- Infectious Diseases
- Cardiology
- Mycology
Background:
- Fungal endocarditis is a rare but severe condition with poor prognosis.
- Candida parapsilosis is a common non-albicans species causing fungal endocarditis, typically in at-risk patients.
- Diagnosis requires high suspicion, echocardiography, and multiple blood cultures.
Observation:
- A 63-year-old male without prior cardiac history or risk factors presented with fungal endocarditis.
- The causative agent was identified as Candida parapsilosis.
- Crucially, the patient did not present with fungemia (fungi in the bloodstream).
Findings:
- This case represents a rare instance of Candida parapsilosis endocarditis in an individual without typical predisposing factors.
- The absence of fungemia in this case underscores the diagnostic complexities.
- The report details the challenges in diagnosing this rare condition and identifies potential predictors of poor outcomes.
Implications:
- Highlights the need for vigilance in diagnosing fungal endocarditis, even in unexpected patient profiles.
- Emphasizes that Candida parapsilosis can cause endocarditis without fungemia, complicating early detection.
- Underscores the importance of understanding risk factors, diagnostic hurdles, and prognostic indicators for improved patient management.
