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[A case of endocarditis caused by Candida glabrata]
1Department of Thoracic Surgery, Yokohama Municipal Citizen's Hospital, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|September 1, 1993
Summary
A diabetic patient died from heart failure after aortic valve replacement for Candida glabrata endocarditis. Autopsy revealed fungal colonies and complications, highlighting treatment challenges for invasive fungal infections.
Area of Science:
- Cardiology
- Infectious Diseases
- Mycology
Background:
- * Aortic valve replacement is a critical procedure for endocarditis.
- * Candida glabrata poses a significant challenge in treating invasive fungal infections.
- * Diabetes mellitus is a known risk factor for various infections.
Observation:
- * A 45-year-old diabetic male underwent aortic valve replacement due to Candida glabrata endocarditis.
- * Post-operative treatment included fluconazole and amphotericin B.
- * Despite antifungal therapy, Candida glabrata persisted in blood cultures.
Findings:
- * The patient experienced sudden collapse and died of heart failure 70 days post-operation.
- * Autopsy revealed suture line insufficiency and perivalvular leakage.
- * Histologic examination showed extensive fungal colonies in the aortic valvular annulus and a mesenteric artery embolus.
Implications:
- * This case underscores the difficulty in eradicating Candida glabrata from prosthetic valves.
- * Inadequate treatment or resistant strains can lead to severe complications like suture dehiscence and embolism.
- * Further research into optimal antifungal strategies for prosthetic valve endocarditis caused by Candida species is warranted.