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Fungal Endocarditis Secondary to Transdermal Fentanyl Patch

Bradley Casey1, Amol Bahekar2, Divyang Patel2

  • 1Internal Medicine, Cape Fear Valley Medical Center, Fayetteville, USA.

Cureus
|June 9, 2023
PubMed

Insights

This case study highlights a rare instance of fungal endocarditis caused by transdermal drug abuse. It emphasizes the importance of considering unusual drug administration methods in diagnosing heart infections.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Cardiology

Background:

  • Fungal endocarditis is a rare but serious cardiac condition.
  • Aspergillus and Candida species are the most common causative agents.
  • Diagnosis requires comprehensive assessment and specific criteria.

Observation:

  • Intravenous drug abuse is a known risk factor for endocarditis.
  • Transdermal drug abuse as a cause of endocarditis is rarely reported.
  • A 33-year-old male presented with non-specific complaints and fungemia.

Findings:

  • The patient intentionally caused dermal abrasion to enhance fentanyl patch absorption.
  • This self-inflicted injury led to fungemia and subsequent endocarditis.
  • The patient refused surgery due to trypanophobia, opting for oral medication.

Implications:

  • This case expands the understanding of risk factors for fungal endocarditis.
  • It underscores the need to investigate all drug administration routes, including transdermal.
  • Physicians must consider non-traditional drug abuse methods in differential diagnoses.
Keywords:
candidemiafentanyl patchfungal endocarditispolysubstance abusetrypanophobia

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