title: Fungal prosthetic valve endocarditis with mycotic aneurysm: Case report.
abstract: Fungal prosthetic valve endocarditis is an extremely severe form of infective endocarditis, with poor prognosis and high mortality despite treatment. Candida albicans is the most common etiological agent for this rare but increasingly frequent condition. We present a case of fungal prosthetic valve endocarditis due to C. albicans following aortic and pulmonary valve replacement in a 38-year-old woman with a history of surgically corrected tetralogy of Fallot, prior infective endocarditis and acute renal failure with need for catheter-based hemodialysis. Antifungal therapy with liposomal amphotericin B was initiated prior to cardiac surgery, in which the bioprostheses were replaced by homografts, providing greater resistance to recurrent infection. During hospitalization, a mycotic aneurysm was diagnosed following an episode of acute arterial ischemia, requiring two vascular surgical interventions. Despite the complications, the patient's outcome was good and she was discharged on suppressive antifungal therapy with oral fluconazole for at least a year. The reported case illustrates multiple risk factors for fungal endocarditis, as well as complications and predictors of poor prognosis, demonstrating its complexity.
authors: Escola de Ciências da Saúde, Universidade do Minho, Braga, Portugal. Electronic address: marianabrandao1993@gmail.com.
authors: Mariana
authors: M
authors: Brandão
authors: Centro de Cirurgia Cardiotorácica, Hospital de São João, Porto, Portugal.
authors: Jorge
authors: J
authors: Almeida
authors: Serviço de Doenças Infecciosas, Hospital de São João, Porto, Portugal.
authors: Rita
authors: R
authors: Ferraz
authors: Serviço de Doenças Infecciosas, Hospital de São João, Porto, Portugal.
authors: Lurdes
authors: L
authors: Santos
authors: Centro de Cirurgia Cardiotorácica, Hospital de São João, Porto, Portugal.
authors: Paulo
authors: P
authors: Pinho
authors: Centro de Cirurgia Cardiotorácica, Hospital de São João, Porto, Portugal.
authors: Jorge
authors: J
authors: Casanova
mesh_terms: D000328:Adult; D000785:Aneurysm, Infected / Q000382:microbiology*; D001705:Bioprosthesis / Q000382:microbiology*; D002176:Candida albicans; D002177:Candidiasis; D004696:Endocarditis / Q000382:microbiology*; D005260:Female; D006350:Heart Valve Prosthesis / Q000382:microbiology*; D006801:Humans; D016459:Prosthesis-Related Infections / Q000382:microbiology*
keywords: Aneurisma micótico; Candida albicans; Endocardite de prótese valvular; Endocardite fúngica; Fungal endocarditis; Homoenxertos; Homografts; Mycotic aneurysm; Prosthetic valve endocarditis