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Native Valve Candida metapsilosis Endocarditis Following a Ruptured Appendix: A Case Report

Koushik Sanku1, Dima Youssef2

  • 1Department of Internal Medicine, East Tennessee State University Quillen College of Medicine, Johnson City, USA.

Cureus
|February 15, 2022
PubMed

Insights

This case study details a rare instance of Candida metapsilosis endocarditis in an immunocompetent individual. Successful treatment involved valve replacement and antifungal therapy, highlighting a viable approach for this uncommon infection.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Cardiology

Background:

  • The Candida parapsilosis complex includes C. parapsilosis, C. orthopsilosis, and C. metapsilosis, with C. metapsilosis being the least virulent.
  • Candida endocarditis, though uncommon, carries a high mortality rate and typically affects prosthetic or damaged heart valves.
  • Native, structurally normal heart valves are rarely implicated in Candida endocarditis.

Observation:

  • A case of Candida metapsilosis endocarditis involving a native aortic valve is presented.
  • The affected individual was a 55-year-old immunocompetent male.
  • The patient presented with symptoms indicative of endocarditis.

Findings:

  • Successful treatment was achieved through a combination of surgical aortic valve replacement and targeted antifungal therapy.
  • This case demonstrates the successful management of a rare fungal endocarditis involving a less virulent Candida species on a native valve.
  • The patient's immunocompetent status and the specific fungal species influenced the treatment approach and outcome.

Implications:

  • This case expands the understanding of Candida metapsilosis as a potential pathogen in native valve endocarditis, even in immunocompetent hosts.
  • The successful surgical and antifungal management strategy provides a valuable clinical precedent for similar rare cases.
  • Further research into the virulence factors and treatment nuances of Candida metapsilosis in endocarditis is warranted.
Keywords:
aortic valve replacementappendix rupturecandida endocarditisechocardiographyimmunocompetentinfective endocarditisinvasive fungal diseasemetapsilosisnative valveparapsilosis

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