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Candida parapsilosis endocarditis: a comparative review of the literature

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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.

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Correspondence to J. Garbino.

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C. Garzoni and V. A. Nobre contributed equally to this manuscript.

The authors declare that there are no conflicts to disclose.

Appendix

Appendix

Table 3 Details of 71 previously reported cases of Candida parapsilosis (1968–2006)

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Garzoni, C., Nobre, V.A. & Garbino, J. Candida parapsilosis endocarditis: a comparative review of the literature. Eur J Clin Microbiol Infect Dis 26, 915–926 (2007). https://doi.org/10.1007/s10096-007-0386-1

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