Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management
Clin Microbiol Rev. 2023 Sep 21;36(3):e0001923. doi: 10.1128/cmr.00019-23. Epub 2023 Jul 13.ABSTRACTFungal endocarditis accounts for 1% to 3% of all infective endocarditis cases, is associated with high morbidity and mortality (>70%), and presents numerous challenges during clinical care. Candida spp. are the most common causes of fungal endocarditis, implicated in over 50% of cases, followed by Aspergillus and Histoplasma spp. Important risk factors for fungal endocarditis include prosthetic valves, prior heart surgery, and injection drug use. The signs and symptoms of fungal endocarditis are nonspecific, and a high degree of clinical suspicion coupled with the judicious use of diagnostic tests is required for diagnosis. In addition to microbiological diagnostics (e.g., blood culture for Candida spp. or galactomannan testing and PCR for Aspergillus spp.), echocardiography remains critical for evaluation of potential infective endocarditis, although radionuclide imaging modalities such as 18F-fluorodeoxyglucose positron emission tomography/computed tomography are increasingly being used. A multimodal treatment approach is necessary: surgery is usually required and should be accompanied by long-term systemic antifungal therapy, such as echinocandin therapy for Candida endocarditis or voriconazole therapy for Aspergillus endocarditis.PMID:37439685 | PMC:PMC10512793 | DOI:10.1128/cmr.00019-23
Source: Clinical Microbiology Reviews - Category: Microbiology Authors: George R Thompson Jeffrey D Jenks John W Baddley James S Lewis Matthias Egger Ilan S Schwartz Johannes Boyer Thomas F Patterson Sharon C-A Chen Peter G Pappas Martin Hoenigl Source Type: research
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