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Publications

Journal Article Review Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Ppublish 44 citations

PubMed: 37439685 DOI: 10.1128/cmr.00019-23

Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management.

Clin Microbiol Rev 36(3):e0001923

Authors: George R Thompson, Jeffrey D Jenks, John W Baddley, James S Lewis, Matthias Egger, Ilan S Schwartz, Johannes Boyer, Thomas F Patterson, Sharon C-A Chen, Peter G Pappas, Martin Hoenigl

Affiliations

  • Department of Internal Medicine, Division of Infectious Diseases, University of California-Davis Medical Center, Sacramento, California, USA.
  • Department of Medical Microbiology and Immunology, University of California-Davis, Davis, California, USA.
  • Durham County Department of Public Health, Durham, North Carolina, USA.
  • Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina, USA.
  • Department of Medicine, Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Department of Pharmacy, Oregon Health & Science University, Portland, Oregon, USA.
  • Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Medicine, Medical University of Graz, Graz, Austria.
  • Department of Medicine, Division of Infectious Diseases, The University of Texas Health Science Center, San Antonio, Texas, USA.
  • Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, New South Wales, Australia.
  • Centre for Infectious Diseases and Microbiology, Westmead Hospital, The University of Sydney, Sydney, New South Wales, Australia.
  • Department of Medicine Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • BioTechMed-Graz, Graz, Austria.

Abstract

Fungal endocarditis accounts for 1% to 3% of all infective endocarditis cases, is associated with high morbidity and mortality (>70%), and presents numerous challenges during clinical care. spp. are the most common causes of fungal endocarditis, implicated in over 50% of cases, followed by and spp. Important risk factors for fungal endocarditis include prosthetic valves, prior heart surgery, and injection drug use. The signs and symptoms of fungal endocarditis are nonspecific, and a high degree of clinical suspicion coupled with the judicious use of diagnostic tests is required for diagnosis. In addition to microbiological diagnostics (e.g., blood culture for spp. or galactomannan testing and PCR for spp.), echocardiography remains critical for evaluation of potential infective endocarditis, although radionuclide imaging modalities such as F-fluorodeoxyglucose positron emission tomography/computed tomography are increasingly being used. A multimodal treatment approach is necessary: surgery is usually required and should be accompanied by long-term systemic antifungal therapy, such as echinocandin therapy for endocarditis or voriconazole therapy for endocarditis.

MeSH

Mycology, Epidemiology, Endocardium, Tomography, Microbiology, Endocarditis, Signs And Symptoms, Diagnosis, Therapeutics

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