Candida tropicalis Endocarditis
1998; Lippincott Williams & Wilkins; Volume: 98; Issue: 1 Linguagem: Italiano
10.1161/01.cir.98.1.90
ISSN1524-4539
AutoresJ. Gerritsen, Jaap T. van Dissel, Harriëtte F. Verwey,
Tópico(s)Fungal Infections and Studies
ResumoHomeCirculationVol. 98, No. 1Candida tropicalis Endocarditis Free AccessOtherPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessOtherPDF/EPUBCandida tropicalis Endocarditis J. G. Gerritsen, J. T. van Dissel and H. F. Verwey J. G. GerritsenJ. G. Gerritsen From the Departments of Cardiology and Infectious Diseases, University Hospital Leiden, and the Department of Cardiology (J.G.G.), Hospital De Weezenlanden, Zwolle, the Netherlands. , J. T. van DisselJ. T. van Dissel From the Departments of Cardiology and Infectious Diseases, University Hospital Leiden, and the Department of Cardiology (J.G.G.), Hospital De Weezenlanden, Zwolle, the Netherlands. and H. F. VerweyH. F. Verwey From the Departments of Cardiology and Infectious Diseases, University Hospital Leiden, and the Department of Cardiology (J.G.G.), Hospital De Weezenlanden, Zwolle, the Netherlands. Originally published7 Jul 1998https://doi.org/10.1161/01.CIR.98.1.90Circulation. 1998;98:90–91A 73-year-old man presented with weakness, weight loss, fever, and disorientation of 3 weeks' duration.Three months earlier, a transurethral prostatectomy had been performed elsewhere. After surgery, the patient developed urosepsis caused by Escherichia coli that was treated with amoxicillin and gentamicin. Also, a Candida species had grown in urine and 1 blood culture. However, no treatment was started against Candida, and species determination was not performed.When the patient was admitted to our hospital, some splinter hemorrhages and conjunctival petechiae were found. The blood pressure was 115/60 mm Hg, and the pulse was strong and regular at 80 bpm. A holosystolic cardiac murmur was heard over the precordium, with a diastolic component compatible with aortic regurgitation. Transthoracic echocardiography showed a large, oscillating vegetation on the aortic valve(Figures 1 and 2, large arrow; Ao indicates aorta ascendens) and an abscess in the aortic root (Figure 2, small arrows). Blood cultures were positive after 1 day for a Candida species that subsequently was shown to be Ctropicalis. Treatment had already been started with amphotericin-B 0.6 mg · kg−1 · d−1 IV and flucytosine 25 mg/kg IV 4 times daily.Awaiting valve replacement with a suitable homograft, the patient suddenly became severely hypotensive (systolic blood pressure <60 mm Hg) and lost consciousness. Reanimation attempts failed. Echocardiography performed during reanimation revealed that the vegetation had herniated through the aortic valve and completely obstructed the left ventricular outflow tract.Postmortem examination confirmed the clinical diagnosis and showed that a herniated fungal vegetation completely obstructed flow to the ascending aorta (Figure 3). Postmortem cultures of the aortic vegetation and abscess grew Ctropicalis. The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.Download figureDownload PowerPoint Figure 1. Download figureDownload PowerPoint Figure 2. Download figureDownload PowerPoint Figure 3. FootnotesCorrespondence to J.G. Gerritsen, Hospital De Weezenlanden, Department of Cardiology, Groot Wezenland 20, 8011 JW Zwolle, Netherlands. Previous Back to top Next FiguresReferencesRelatedDetailsCited By Prabhudas-Strycker K, Butt S and Reddy M (2020) Candida tropicalis endocarditis successfully treated with AngioVac and micafungin followed by long-term isavuconazole suppression, IDCases, 10.1016/j.idcr.2020.e00889, 21, (e00889), . Giuliano S, Guastalegname M, Russo A, Falcone M, Ravasio V, Rizzi M, Bassetti M, Viale P, Pasticci M, Durante-Mangoni E and Venditti M (2017) Candida endocarditis: systematic literature review from 1997 to 2014 and analysis of 29 cases from the Italian Study of Endocarditis , Expert Review of Anti-infective Therapy, 10.1080/14787210.2017.1372749, 15:9, (807-818), Online publication date: 2-Sep-2017. Badiee P, Alborzi A, Shakiba E, Ziyaeyan M and Pourabbas B (2009) Molecular diagnosis of Aspergillus endocarditis after cardiac surgery, Journal of Medical Microbiology, 10.1099/jmm.0.004531-0, 58:2, (192-195), Online publication date: 1-Feb-2009. Dassanayake R, Samaranayake Y, Yau J and Samaranayake L (2006) DNA FINGERPRINTING ELICITED EVOLUTIONARY TREND OF ORAL CANDIDA TROPICALIS ISOLATES FROM DIVERSE GEOGRAPHIC LOCALES, Indian Journal of Medical Microbiology, 10.1016/S0255-0857(21)02348-3, 24:3, (186-194), Online publication date: 1-Jul-2006. Steinbach W, Perfect J, Cabell C, Fowler V, Corey G, Li J, Zaas A and Benjamin D (2005) A meta-analysis of medical versus surgical therapy for Candida endocarditis, Journal of Infection, 10.1016/j.jinf.2004.10.016, 51:3, (230-247), Online publication date: 1-Oct-2005. Iarussi D, Martino V, Pergola V, Renzo G, Tripodi M, Utili R and Calabro R (2003) Endocarditis Abscess of the Aortic Annulus Involving the Left Ventricular Inferior Wall and Causing a Moderate Aortic Systolic Obstruction:. Diagnosis by Transthoracic and Transesophageal Echocardiography, Echocardiography, 10.1046/j.1540-8175.2003.00008.x, 20:1, (63-66), Online publication date: 1-Jan-2003. Pierrotti L and Baddour L (2002) Fungal Endocarditis, 1995–2000, Chest, 10.1378/chest.122.1.302, 122:1, (302-310), Online publication date: 1-Jul-2002. FELD S, ALMAGOR Y, VAUGHN W, LEON. M and SERRUYS P (2002) Predictors of Clinical Outcome Following NIR Stent Implantation for Coronary Artery Disease: Analysis of the Results of the First International New Intravascular Rigid-Flex Endovascular Stent Study (FINESS Trial), Journal of Interventional Cardiology, 10.1111/j.1540-8183.2002.tb01025.x, 15:1, (1-6), Online publication date: 1-Feb-2002. Basmadjian A, Ducharme A, Ugolini P, Petitclerc R, Leung T and Tardif J (2000) Obstruction of left ventricular outflow tract by vegetation and periaortic abscess, Journal of the American Society of Echocardiography, 10.1067/mje.2000.104900, 13:9, (869-872), Online publication date: 1-Sep-2000. Segal E and Elad D (2010) Candidiasis Topley & Wilson's Microbiology and Microbial Infections, 10.1002/9780470688618.taw0157 July 7, 1998Vol 98, Issue 1 Advertisement Article InformationMetrics Copyright © 1998 by American Heart Associationhttps://doi.org/10.1161/01.CIR.98.1.90 Originally publishedJuly 7, 1998 PDF download Advertisement
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