Fungal multivalvular endocarditis: literature review and case report

Jésser M. Herrera-Salgado, Coordination of Medical Education and Research, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
Edgar O. Berrios-Muñiz, Critical Care Division, Hospital Militar Alejandro Dávila Bolaños, Managua, Nicaragua
Yader E. Altamirano-Ramírez, Critical Care Division, Hospital Militar Alejandro Dávila Bolaños, Managua, Nicaragua
Vilma E. Gutiérrez-Casco, Critical Care Division, Hospital Militar Alejandro Dávila Bolaños, Managua, Nicaragua
Jesús C. Briones-Garduño, Medical Education and Research Coordination. Hospital Materno Perinatal Mónica Pretelini Sáenz, Secretaría de Salud, Toluca, State of Mexico, Mexico
Sindy A. Gutiérrez-Chavarría, Adults Bone Marrow Transplant Unit, Hospital General de Tlahuac Dra. Matilde Petra Montoya Lafragua, ISSSTE, Mexico City. Mexico

The incidence of fungal endocarditis (FEs) has decreased in most developed countries with access to harm-reduction policies and with improved infection control procedures during cardiac surgery. Use of specific blood culture bottles for diagnosis of FEs has decreased due to the optimization of media and automated culture systems. New antifungal agents available since the early 2000s may represent a dramatic improvement for FEs. The optimum antifungal therapy still remains debatable. Treating Candida endocarditis can be difficult because the Candida species can form biofilms on native and prosthetic heart valves. Combined treatment appears superior to monotherapy. Combination of antifungal therapy and surgical debridement might bring about better prognosis. In this clinical case report, we aim to make a literature review and present a challenging and rare clinical case.