Fungal endocarditis is a rare and fatal condition most frequently caused by species of the genera and . Fever and changing heart murmur are the most common clinical manifestations. The diagnosis of fungal endocarditis is challenging, with prosthetic valve endocarditis being extremely difficult to diagnose. The optimal management of the condition still remains debatable. We present a case of prosthetic valve endocarditis caused by , managed empirically with liposomal amphotericin B, which was later shifted to combination therapy with high-dose echinocandin and fluconazole, but had a fatal outcome because the patient could not undergo timely surgical intervention. Treating endocarditis cases is difficult because of their biofilm production on native and prosthetic heart valves. A combined approach consisting of a high index of clinical suspicion, early diagnosis using serological markers followed by culture or PCR and prompt initiation of appropriate antifungals may aid in improving outcomes.
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http://dx.doi.org/10.1099/acmi.0.000462.v4 | DOI Listing |
Kardiochir Torakochirurgia Pol
December 2024
Department of Cardiovascular Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Introduction: Patients who need tricuspid valve replacement (TVR) surgery often have permanent transvalvular pacemaker (PM) leads, which pose an important challenge in lead management.
Aim: The objective of this study was to evaluate the results of paravalvular positioning of a permanent pacemaker lead during TVR surgery.
Material And Methods: Between 2014 and 2024, a total of 15 patients who had previously had a transvenous pacemaker system underwent TVR.
Background: Valve-related haemolysis is a known complication following prosthetic valve surgery. Haemolysis after transcatheter aortic valve implantation (TAVI) has been reported in some studies, all of which were non-critical. Data related to haemolysis associated with new-generation balloon-expandable valve (BEV) are scarce.
View Article and Find Full Text PDFPathogens
November 2024
Department of Cardiac Surgery, Centre Cardiologique du Nord, 93200 Saint-Denis, France.
Prosthetic valve endocarditis (PVE) is the medical term used to describe a focus of infection involving a valvular substitute within the heart. It is a significant concern in the field of cardiology, and the epidemiology of PVE has seen notable developments over the last five decades. The disease currently affects an older demographic and is becoming increasingly prevalent in patients with transcatheter-implanted valves.
View Article and Find Full Text PDFLife (Basel)
December 2024
Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Bvd, 050474 Bucharest, Romania.
Background: Histological findings of infective endocarditis (IEs) in mechanical valves present a complex diagnostic challenge owing to the lack of a precise definition. This ambiguity is further complicated by the natural degenerative processes that occur in the mechanical valves over time. Consequently, pathologists and clinicians face significant difficulties in distinguishing between genuine infective processes and the normal wear and tear of mechanical valves.
View Article and Find Full Text PDFAntibiotics (Basel)
November 2024
Division of Pulmonary and Critical Care, Unity Point Health at St. Luke's Regional Medical Center, 2720 Stone Park Blvd, Sioux City, IA 51104, USA.
Infective endocarditis (IE) is a life-threatening condition with increasing global incidence, primarily caused by , especially methicillin-resistant strains (MRSA). Biofilm formation by is a critical factor in pathogenesis, contributing to antimicrobial resistance and complicating the treatment of infections involving prosthetic valves and cardiovascular devices. Biofilms provide a protective matrix for MRSA, shielding it from antibiotics and host immune defenses, leading to persistent infections and increased complications, particularly in cases involving prosthetic materials.
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