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- Title
ENDOCARDITA MICOTICĂ DE VALVĂ MITRALĂ. PREZENTARE DE CAZ.
- Authors
ŢILEA, IOAN; BRÎNZANIUC, KLARA; ŢILEA, BRÎNDUŞA; SUCIU, HORAŢIU; OPRIŞ, MIHAELA; GOMOTÂRCEANU, FLORIN; ISPAS, MIHAELA; TĂTAR, CRISTINA MARIA; DOBREANU, DAN
- Abstract
Background: Candidal endocarditis is an inflammatory and proliferative disease of the endocardium that mainly affects valvular structures. Fungal aetiology is uncommon and appears less frequently when vegetation appears on native valves. Case report: We present a case of native mitral valve fungal endocarditis in a patient with no apparent risk factors with a history of infectious syndrome. Laboratory findings revealed blood cultures positive for Candida albicans and transthoracic/transesophageal echocardiography revealed an mobile structure over posterior mitral leaflet. During adequate antifungal therapy, case evolution was slowly favourable; when haemodynamic status was stable the patient underwent mitral valve replacement with a 29 bileaflet St. Jude prosthesis. Pathologic exam confirmed etiology. Discussions: Fungal endocarditis is a serious disease associated with a high mortality. Fungi are responsible for less than 10% of cases of infective endocarditis. Although the majority of these are caused by Candida species, infections with opportunistic mold are seen in patients with previous valve operations. Additional experience is needed to optimize antifungal selection, particularly as relates to combination antifungal therapy and the role of newer azoles, such as posaconazole; the echinocandins, such as caspofungin; or the allylamine terbinafine in synergy. Conclusions: whenever the diagnosis is suspected, antifungal therapy must be started and appropriate surgery (prosthetic valve replacement) should be considered.
- Subjects
ENDOCARDITIS; ENDOCARDIUM diseases; HEART valve diseases; ETIOLOGY of diseases; ANTIFUNGAL agents; SURGERY
- Publication
Clujul Medical, 2011, p19
- ISSN
1222-2119
- Publication type
Article