Related Experiment Video
Updated: Aug 16, 2025
A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
Published on: September 20, 2018
Cryptococcus neoformans endocarditis in an immunocompetentpatient a case report
Colin N McGuire1, Dylan J Walter2
1Department of Internal Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC, 20007, USA.
Insights
Cryptococcus neoformans can cause invasive fungal infections, typically in immunocompromised individuals. This case highlights native valve endocarditis in a patient without immunosuppression, emphasizing the need for broader clinical suspicion.
Area of Science:
- Infectious Diseases
- Cardiology
- Mycology
Background:
- Cryptococcus neoformans commonly causes pneumonia or meningitis in immunocompromised patients.
- Endocarditis due to C. neoformans is rare, predominantly reported in immunosuppressed individuals with cardiac devices or prosthetic valves.
Observation:
- A patient with substance abuse disorder and heart failure presented with fever, altered mental status, and embolic phenomena.
- Native tricuspid valve vegetations and positive blood cultures for C. neoformans were identified in the absence of immunosuppression.
Findings:
- This case represents a rare instance of native valve endocarditis caused by Cryptococcus neoformans.
- Fungal fungemia typically presents as pulmonary or meningeal infections, with endocarditis being an infrequent manifestation.
Implications:
- Clinicians should maintain a high index of suspicion for C. neoformans endocarditis, even in non-immunosuppressed patients with native valves.
- The findings challenge the traditional understanding of C. neoformans as solely an opportunistic pathogen in specific patient groups.
Background:
Cryptococcus neoformans is an invasive fungal infection commonly affecting immunocompromised patients as pneumonia or meningitis. More rarely, case reports describe Cryptococcus neoformans endocarditis, though nearly exclusively among patients with active immunosuppression, implanted cardiac devices or prosthetic valves.
Case Presentation:
We report the case of a patient with underlying substance abuse disorder and systolic heart failure presenting with fever, altered mental status, and shower emboli subsequently found to have native tricuspid valve vegetations and blood cultures positive for cryptococcus neoformans in the absence of immunosuppression.
Conclusions:
Historically, Cryptococcus neoformans fungemia manifests clinically as pneumonia or meningitis among the immunosuppressed. There have been rare reports of endocarditis in this population and even fewer reports of native valve endocarditis exist. The present case along with mortality reported in prior literature, suggest suspicion must be maintained in the absence of immunosuppression, even in patients with native valves.
Related Concept Videos
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:25Endocarditis I: Introduction
01:18Endocarditis III: Medical Management
01:29Endocarditis IV: Nursing Management
01:21Myocarditis I: Introduction
01:22Pericarditis I: Introduction