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Fungal endocarditis: need for guidelines in evaluating therapy. Experience with two patients previously reported
The Journal of Thoracic and Cardiovascular Surgery
|February 1, 1977
Summary
Fungal endocarditis treatment requires careful reporting. Patients on antifungal chemotherapy may appear cured but still have active disease, necessitating longer follow-up and specific reporting guidelines.
Area of Science:
- Infectious Diseases
- Cardiology
- Mycology
Background:
- Fungal endocarditis treatment success is increasingly reported.
- However, challenges in diagnosis and treatment monitoring persist.
Observation:
- Two patients, previously reported as disease-free, died from active fungal endocarditis.
- Both patients received antifungal chemotherapy during their reported recovery periods.
Findings:
- Clinical signs of fungal endocarditis can be suppressed by chemotherapy.
- Laboratory diagnostics may offer uncertain reliability in assessing treatment efficacy.
- Current reporting practices may overstate treatment success.
Implications:
- Guidelines for reporting fungal endocarditis treatment outcomes are proposed.
- These include avoiding 'cure' claims during chemotherapy, assessing fungemia, and ensuring 1-2 years of follow-up.
- Serologic studies show potential utility in monitoring disease activity.