Candida parapsilosis endocarditis: a comparative review of the literature

Eur J Clin Microbiol Infect Dis. 2007 Dec;26(12):915-26. doi: 10.1007/s10096-007-0386-1.

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Candida* / classification
  • Candidiasis / diagnosis
  • Candidiasis / drug therapy
  • Candidiasis / microbiology*
  • Endocarditis / drug therapy
  • Endocarditis / microbiology*
  • Humans
  • Male

Substances

  • Antifungal Agents