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01.12.2007 | Concise Article | Ausgabe 12/2007

European Journal of Clinical Microbiology & Infectious Diseases 12/2007

Candida parapsilosis endocarditis: a comparative review of the literature

Zeitschrift:
European Journal of Clinical Microbiology & Infectious Diseases > Ausgabe 12/2007
Autoren:
C. Garzoni, V. A. Nobre, J. Garbino
Wichtige Hinweise
C. Garzoni and V. A. Nobre contributed equally to this manuscript.
The authors declare that there are no conflicts to disclose.

Abstract

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.

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