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Candida parapsilosis endocarditis: a comparative review of the literature

Garzoni, C. ; Nobre, V. ; Garbino, J.

In: European Journal of Clinical Microbiology & Infectious Diseases, 2007, vol. 26, no. 12, p. 915-926

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    Title
    • Candida parapsilosis endocarditis: a comparative review of the literature
    Author
    • Garzoni, C.. Division of Infectious Diseases, University Hospitals of Geneva, 24 Rue Micheli-du-Crest, 1211, Geneva 14, Switzerland
    • Nobre, V.. Internal Medicine Division, Federal University of Minas Gerais, Rua Mirabela 424, Belo Horizonte, Minas Gerais, Brazil
    • Garbino, J.. Division of Infectious Diseases, University Hospitals of Geneva, 24 Rue Micheli-du-Crest, 1211, Geneva 14, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • European Journal of Clinical Microbiology & Infectious Diseases, 2007, vol. 26, no. 12, p. 915-926. Springer-Verlag
    Other Version
    Classification
    • Health
    OAI-PMH Identifier
    • oai:doc.rero.ch:319496
    Summary
    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