Copyright © 1995 by the European Society of Cardiology.
© 1995 The European Society of Cardiology
Fungal endocarditis
Infectious Diseases Units, Sheba Medical Center, Tel Hashomer and Meir Hospital, Kfar-Saba Tel Aviv University School of Medicine Israel
Correspondence to: Ethan Rubinstein, MD, Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, 52621. Israel.
Fungal endocarditis has become an important infection associated with medical progress and a modern lifestyle. The most common organisms isolated from patients with fungal endocarditis are: Aspergillus spp.; Candida spp. and Torulopsis glabrata. Men are more frequently affected than women and predisposing factors include: previous cardiac surgery, antibiotic use and hyperalimentation, long-term i.v. catheters. Common clinical findings in patients with endocarditis include: fever, changing murmurs, peripheral emboli which are characteristically large and chorioretinitis. Characteristic laboratory findings are absent and positive blood cultures are obtained only in a relatively small number of patients. Characteristically, Aspergillus spp. almost never grow in blood cultures and must be isolated from removed emboli, from the diseased valve or from infected foreign bodies. Overall survival in patients with fungal endocarditis is rather poor, and hardly exceeds 50%. In general, a combined surgical–medical approach would yield the best results. New therapeutic modalities are needed in order to improve the prognosis of fungal endocarditis.
Key Words: Fungal endocarditis • open heart surgery • intravenous drug users
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