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Fungal Endocarditis: A Case Report.

Margarida Brito Monteiro1, Rita Sismeiro1, Catarina Negrão1

  • 1Internal Medicine, Hospital Prof. Doutor Fernando Fonseca, Amadora, PRT.

Cureus
|January 10, 2022
PubMed
Summary

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.

Keywords:
aortic vegetationcandida parapsilosisembolic phenomenaendocarditisfungal endocarditis

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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.