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Candida endocarditis in a child with hyperimmunoglobulinemia E syndrome
A B Yates1, D Mehrotra, J E Moffitt
1University of Mississippi Medical Center, School of Medicine, Department of Pediatrics, Jackson 39216-4505, USA.
The Journal of Allergy and Clinical Immunology
|June 1, 1997
Summary
Hyperimmunoglobulin E syndrome (HIE) patients face recurrent infections. A rare case details Candida endocarditis in a child with HIE, highlighting fungal endocarditis as a potential complication, especially with central lines.
Area of Science:
- Immunology
- Infectious Diseases
- Cardiology
Background:
- Hyperimmunoglobulin E syndrome (HIE) is characterized by extremely elevated serum IgE levels and recurrent infections.
- Patients with HIE are prone to staphylococcal abscesses and other bacterial and fungal infections.
Observation:
- A 46-month-old boy with HIE presented with Candida endocarditis and sepsis.
- The patient had an indwelling central line and a history of oral thrush.
- Clinical presentation included dark urine, new murmur, petechial rash, shock, and disseminated intravascular coagulation.
Findings:
- Serum IgE levels were markedly elevated (38,664 and 44,510).
- Blood and tricuspid valve cultures confirmed Candida albicans infection.
- The fungal mass extended through the tricuspid valve, necessitating surgical intervention.
Implications:
- This is the first reported case of Candida endocarditis in a patient with HIE.
- Fungal endocarditis is a rare but serious complication in HIE patients, particularly those with indwelling central catheters.
- Early recognition and aggressive management are crucial for improving outcomes in such complex cases.
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