Fungal Endocarditis: A Rare Case of Multiple Arterial Embolization

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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
14:58

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

9.8K

Francisca Beires1, Raquel Rocha2, Diana Mata3

  • 1Internal Medicine, Hospital Pedro Hispano, Senhora da Hora, PRT.

Cureus
|February 6, 2023
PubMed

Insights

Fungal endocarditis is a rare, fatal condition often affecting postsurgical patients. Early diagnosis and multidisciplinary care, including antifungal therapy and surgery, are crucial for successful outcomes.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Neurology

Background:

  • Fungal endocarditis (FE) is a rare but life-threatening infection of the heart valves.
  • It predominantly affects immunocompromised individuals with prior cardiac or non-cardiac surgery.
  • High mortality rates (up to 75%) underscore the urgency of prompt diagnosis and treatment.

Observation:

  • A patient with a history of aortic valve replacement and carotid endarterectomy presented with fever and neurological deficits.
  • Cerebral complications, including abscesses, are common due to frequent embolization (44% of cases).
  • Neurological deterioration occurred during hospitalization, with a left frontal lobe abscess identified.

Findings:

  • The patient was diagnosed with fungal endocarditis.
  • An aggressive, combined treatment approach involving antifungal therapy and surgical aortic valve replacement was initiated.
  • Despite a cerebral abscess and poor prognosis, the patient experienced a slow recovery.

Implications:

  • This case emphasizes the need for a high index of suspicion for FE in at-risk populations.
  • Successful management requires a multidisciplinary team approach involving infectious disease specialists, cardiac surgeons, and neurologists.
  • Aggressive, combined therapeutic strategies can lead to favorable outcomes even in complex cases.
Keywords:
adult cardiac surgeryantifungal medicationscandida parapsilosiscerebral abscessinfective endocarditis complicationsinvasive fungal infectionssurgical aortic valve replacement (savr)

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