Fungal endocarditis in critically ill children.
All cases of infective endocarditis occurring from January 1990 to December 1996 at our institution were reviewed, with a special focus on fungal endocarditis. Five critically ill children with fungal endocarditis and eleven children with bacterial endocarditis were recorded. The proportion of fungal endocarditis in our series was 5/16 (31%) and Candida albicans (4/5) was the most common fungal pathogen. Only one patient required heart surgery because of a loose patch but all the others were treated only by medical management for cure. The hospital survival rate was 80% (4/5) and the overall long-term survival rate was 60% (3/5) with only one death directly related to fungal infection.


CONCLUSIONS
Despite the small number of cases, a sole medical approach including amphotericin B and long-term fluconazole prophylaxis for the treatment of fungal endocarditis in critically ill children seems to offer an alternative to surgical treatment which may be kept for failure of medical treatment.
Aspesberro
F
F
Unité de Cardiologie Pédiatrique, Hôpital des Enfants, Geneva, Switzerland.
Beghetti
M
M
Oberhänsli
I
I
Friedli
B
B
D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004696:Endocarditis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D016469:Fungemia / Q000150:complications*; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome
D000935:Antifungal Agents; D000666:Amphotericin B