Candida parapsilosis endocarditis: a comparative review of the literature.
Fungal endocarditis (FE) is an uncommon disease, and while accounting for only 1.3-6% of all cases of infectious endocarditis, it carries a high mortality risk. Although Candida albicans represents the main etiology of FE, C. parapsilosis is the most common non-albicans species. We report the case of a 32-year-old man with a history of prior intravenous drug (IVD) use hospitalized with endocarditis due to C. parapsilosis and review all 71 additional cases documented in the literature. A retrospective analysis of the 72 C. parapsilosis cases compared to 52 recently reviewed cases of C. albicans endocarditis was conducted to identify organism-specific clinical peculiarities. The most common predisposing factor for C. parapsilosis endocarditis (41/72; 57.4%) involved prosthetic valves followed by IVD use (12/72; 20%). Peripheral embolic and/or hemorrhagic events occurred in 28/64 (43.8%) patients, mostly in cerebral and lower limb territories. Overall mortality was 41.7%. Combined surgical and clinical treatment was associated with a lower mortality. Few patients received the newer antifungal agents, and it would appear that more experience is required for their use in the treatment of C. parapsilosis endocarditis.
Garzoni
C
C
Division of Infectious Diseases, University Hospitals of Geneva, 24 Rue Micheli-du-Crest, Geneva 14, Switzerland. Christian.Garzoni@insel.ch
Nobre
V A
VA
Garbino
J
J
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000145:classification; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004696:Endocarditis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male