Fungal Endocarditis: Update on Diagnosis and Management

Am J Med. 2016 Oct;129(10):1037-43. doi: 10.1016/j.amjmed.2016.05.012. Epub 2016 Jun 4.

Abstract

Fungal endocarditis is an extremely debilitating disease associated with high morbidity and mortality. Candida spp. are the most common isolated organisms in fungal endocarditis. It is most prevalent in patients who are immunosuppressed and intravenous drug users. Most patients present with constitutional symptoms, which are indistinguishable from bacterial endocarditis, hence a high index of suspicion is required for pursuing diagnosis. Diagnosis of fungal endocarditis can be very challenging: most of the time, blood cultures are negative or take a long time to yield growth. Fungal endocarditis mandates an aggressive treatment strategy. A medical and surgical combined approach is the cornerstone of therapy.

Keywords: Aspergillus; Candida; Emboli; Endocarditis; Fungal.

Publication types

  • Review

MeSH terms

  • Antifungal Agents / therapeutic use
  • Aspergillosis / diagnosis
  • Aspergillosis / epidemiology
  • Aspergillosis / immunology
  • Aspergillosis / therapy
  • Candidiasis / diagnosis
  • Candidiasis / epidemiology
  • Candidiasis / immunology
  • Candidiasis / therapy
  • Cardiac Surgical Procedures
  • Defibrillators, Implantable
  • Device Removal
  • Echocardiography
  • Endocarditis / diagnosis*
  • Endocarditis / epidemiology
  • Endocarditis / immunology
  • Endocarditis / therapy
  • Fungemia / diagnosis
  • Fungemia / epidemiology
  • Fungemia / immunology
  • Fungemia / therapy
  • Heart Valve Prosthesis
  • Histoplasmosis / diagnosis
  • Histoplasmosis / epidemiology
  • Histoplasmosis / immunology
  • Histoplasmosis / therapy
  • Humans
  • Immunocompromised Host / immunology
  • Mycoses / diagnosis*
  • Mycoses / epidemiology
  • Mycoses / immunology
  • Mycoses / therapy
  • Prosthesis-Related Infections / diagnosis*
  • Prosthesis-Related Infections / epidemiology
  • Prosthesis-Related Infections / immunology
  • Prosthesis-Related Infections / therapy
  • Substance Abuse, Intravenous / epidemiology

Substances

  • Antifungal Agents