Fungal prosthetic endocarditis presenting as intracranial hemorrhage

Area of Science:

• Cardiology
• Infectious Diseases
• Pathology

Background:

• Fungal endocarditis is a rare but severe infection affecting heart valves, accounting for less than 3% of all infective endocarditis cases.
• Prosthetic valves are particularly vulnerable, with fungal infections comprising approximately 4% of prosthetic valve endocarditis, especially within the first three months post-surgery.
• This condition has a high mortality rate, reaching up to 62.5%, with Candida species being the most frequent pathogen, often acquired through horizontal transmission.

Purpose of the Study:

• To report the autopsy findings in a patient with fungal prosthetic valve endocarditis.
• To emphasize the clinical presentation of embolic phenomena in fungal prosthetic valve endocarditis.
• To highlight the association between fungal prosthetic valve endocarditis and intracranial hemorrhage.

Main Methods:

• Autopsy examination of a 51-year-old male with a recent prosthetic bi-leaflet mitral valve replacement.
• Histopathological analysis to confirm fungal endocarditis and identify the causative organism.
• Correlation of autopsy findings with clinical history and presentation.

Main Results:

• The autopsy revealed extensive intracranial hemorrhage.
• Evidence of fungal endocarditis on the prosthetic mitral valve was confirmed.
• The findings suggest a link between the fungal prosthetic valve endocarditis and the fatal intracranial hemorrhage.

Conclusions:

• Fungal prosthetic valve endocarditis is a critical condition with a high mortality rate.
• Embolic events, such as intracranial hemorrhage, are significant clinical manifestations.
• This case underscores the importance of considering fungal endocarditis in patients with prosthetic valves presenting with neurological complications.