Candida Parapsilosis Endocarditis: a Comparative Review of the Literature

Overview

Journal Eur J Clin Microbiol Infect Dis

Publisher Springer

Specialties Infectious Diseases
Microbiology

Date 2007 Sep 7

PMID 17805589

Citations 25

Authors

C Garzoni

V A Nobre

J Garbino

Affiliations

Soon will be listed here.

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.

Citing Articles

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References

Stulz P, Hasse J, Mihatsch J, GRADEL E . Candida endocarditis after heart valve replacement (successful management with reoperation and local disinfection). J Cardiovasc Surg (Torino). 1980; 21(3):255-60. View

Wallbridge D, McCartney A, Richardson M . Fluconazole in the treatment of Candida prosthetic valve endocarditis. Mycoses. 1993; 36(7-8):259-61. DOI: 10.1111/j.1439-0507.1993.tb00761.x. View

Rubinstein E, Noriega E, Simberkoff M, Holzman R, Rahal Jr J . Fungal endocarditis: analysis of 24 cases and review of the literature. Medicine (Baltimore). 1975; 54(4):331-4. View

Hoeprich P, Ingraham J, Kleker E, Winship M . Development of resistance to 5-fluorocytosine in Candida parapsilosis during therapy. J Infect Dis. 1974; 130(2):112-8. DOI: 10.1093/infdis/130.2.112. View

Johnston B, Schlech 3rd W, Marrie T . An outbreak of Candida parapsilosis prosthetic valve endocarditis following cardiac surgery. J Hosp Infect. 1994; 28(2):103-12. DOI: 10.1016/0195-6701(94)90137-6. View

Dismukes W, Karchmer A, Buckley M, Austen W, SWARTZ M . Prosthetic valve endocarditis. Analysis of 38 cases. Circulation. 1973; 48(2):365-77. DOI: 10.1161/01.cir.48.2.365. View

Lozano P, Flores D, Blanes I, Rimbau E, Corominas C, Julia J . Acute lower limb ischemia complicating endocarditis due to Candida parapsilosis in a drug abuser. Ann Vasc Surg. 1994; 8(6):591-4. DOI: 10.1007/BF02017417. View

Moudgal V, Little T, Boikov D, Vazquez J . Multiechinocandin- and multiazole-resistant Candida parapsilosis isolates serially obtained during therapy for prosthetic valve endocarditis. Antimicrob Agents Chemother. 2005; 49(2):767-9. PMC: 547225. DOI: 10.1128/AAC.49.2.767-769.2005. View

Grehl T, Cohn L, Angell W . Management of Candida endocarditis. J Thorac Cardiovasc Surg. 1972; 63(1):118-20. View

10.

Samelson L, Lerner S, Resnekov L, Anagnostopoulos C . Relapse of Candida parapsilosis endocarditis after long-term suppression with flucytosin: retreatment with valve replacement and ketoconazole. Ann Intern Med. 1980; 93(6):838-9. DOI: 10.7326/0003-4819-93-6-838. View

11.

Li J, Sexton D, Mick N, Nettles R, Fowler Jr V, Ryan T . Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000; 30(4):633-8. DOI: 10.1086/313753. View

12.

Senba M, Watanabe K, Yoshida K, Ochi S, Matsumoto K, Yano K . Endocarditis caused by Candida parapsilosis. Southeast Asian J Trop Med Public Health. 1992; 23(1):138-41. View

13.

Auger P, Pelletier L, DYRDA I, MARQUIS G, Montplaisir S, Albert G . [Endocarditis caused by Candida parapsilosis (para-krusei)]. Arch Mal Coeur Vaiss. 1983; 76(10):1231-4. View

14.

Baddour L . Long-term suppressive therapy for Candida parapsilosis-induced prosthetic valve endocarditis. Mayo Clin Proc. 1995; 70(8):773-5. DOI: 10.4065/70.8.773. View

15.

Weems Jr J, Chamberland M, Ward J, Willy M, Padhye A, Solomon S . Candida parapsilosis fungemia associated with parenteral nutrition and contaminated blood pressure transducers. J Clin Microbiol. 1987; 25(6):1029-32. PMC: 269130. DOI: 10.1128/jcm.25.6.1029-1032.1987. View

16.

Lipton S, Hickey W, Morris J, Loscalzo J . Candidal infection in the central nervous system. Am J Med. 1984; 76(1):101-8. DOI: 10.1016/0002-9343(84)90757-5. View

17.

Saito Y, Takahashi M, Sato A, Katsuki T, Ikeda U, Shimada K . Isolated tricuspid valve endocarditis due to Candida parapsilosis associated with long-term central venous catheter implantation. Intern Med. 2001; 40(5):403-4. DOI: 10.2169/internalmedicine.40.403. View

18.

Lejko-Zupanc T, Kozelj M . A case of recurrent Candida parapsilosis prosthetic valve endocarditis: cure by medical treatment alone. J Infect. 1997; 35(1):81-2. DOI: 10.1016/s0163-4453(97)91145-2. View

19.

Girmenia C, Martino P, De Bernardis F, Gentile G, Boccanera M, Monaco M . Rising incidence of Candida parapsilosis fungemia in patients with hematologic malignancies: clinical aspects, predisposing factors, and differential pathogenicity of the causative strains. Clin Infect Dis. 1996; 23(3):506-14. DOI: 10.1093/clinids/23.3.506. View

20.

Watanakunakorn C, Carleton J, GOLDBERG L, Hamburger M . Candida endocarditis surrounding a Starr-Edwards prosthetic valve. Recovery of candida in hypertonic medium during treatment. Arch Intern Med. 1968; 121(3):243-5. View