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Cryptococcus neoformans endocarditis in an immunocompetentpatient a case report
Colin N McGuire1, Dylan J Walter2
1Department of Internal Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC, 20007, USA.
BMC Cardiovascular Disorders
|December 23, 2022
Summary
Cryptococcus neoformans can cause invasive fungal infections, typically in immunocompromised individuals. This case highlights native valve endocarditis in a patient without immunosuppression, emphasizing the need for broader clinical suspicion.
Area of Science:
- Infectious Diseases
- Cardiology
- Mycology
Background:
- Cryptococcus neoformans commonly causes pneumonia or meningitis in immunocompromised patients.
- Endocarditis due to C. neoformans is rare, predominantly reported in immunosuppressed individuals with cardiac devices or prosthetic valves.
Observation:
- A patient with substance abuse disorder and heart failure presented with fever, altered mental status, and embolic phenomena.
- Native tricuspid valve vegetations and positive blood cultures for C. neoformans were identified in the absence of immunosuppression.
Findings:
- This case represents a rare instance of native valve endocarditis caused by Cryptococcus neoformans.
- Fungal fungemia typically presents as pulmonary or meningeal infections, with endocarditis being an infrequent manifestation.
Implications:
- Clinicians should maintain a high index of suspicion for C. neoformans endocarditis, even in non-immunosuppressed patients with native valves.
- The findings challenge the traditional understanding of C. neoformans as solely an opportunistic pathogen in specific patient groups.
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