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[Endocarditis caused by Candida parapsilosis (para-krusei)]
Abstract:
This paper describes a case of Candida Parapsilosis endocarditis in a patient with a mitral valve prosthesis implanted two years previously. This history started with a cerebrovascular accident associated with pyrexia. A complex medico-surgical therapeutic approach controlled the infection. This consisted of systemic and local (immersion of the prosthesis) antifungal therapy, bathing the left heart chambers in 5 p. 100 iodine solution and two valve replacements at 8 months intervals. The second surgery was not related to recurrence of the candida infection but to a perivalvular leak attributed to the insertion of the prosthesis into tissues inflamed by recent infection. Despite the improvement in the prognosis of fungal infection due to an early surgical approach, it is still essential to try and prevent the disease, the mortality rate still being over 80 p. 100. It is essential to be very careful when using intravenous catheters and aerosols; the indications of antibiotherapy must also be respected.
Insights
This case study details Candida Parapsilosis endocarditis in a patient with a mitral valve prosthesis. A multidisciplinary approach involving antifungal therapy and valve replacement successfully managed the infection.
Area of Science:
- Infectious Diseases
- Cardiology
- Surgical Innovation
Background:
- Endocarditis presents a significant risk in patients with prosthetic heart valves.
- Candida Parapsilosis is an opportunistic fungal pathogen that can cause severe infections.
Observation:
- A patient with a two-year-old mitral valve prosthesis developed Candida Parapsilosis endocarditis, initially presenting with cerebrovascular accident and pyrexia.
- The infection led to a perivalvular leak after initial treatment, necessitating a second valve replacement.
Findings:
- A complex therapeutic strategy combining systemic and local antifungal treatments, iodine irrigation, and staged valve replacements was effective in controlling the infection.
- Early surgical intervention, alongside appropriate antifungal therapy, is crucial for managing prosthetic valve endocarditis.
Implications:
- Despite advances, fungal endocarditis carries a high mortality rate, emphasizing the need for preventative measures.
- Vigilance in the use of invasive devices like intravenous catheters and aerosols, and adherence to antibiotic guidelines, are critical for prevention.