Definition
Fungal endocarditis refers to a rare and serious condition characterized by the presence of a fungal infection in the endocardium, which is the inner lining of the heart chambers and heart valves.
Causes
Fungal endocarditis is primarily caused by the colonization and invasion of the endocardium by fungi, such as Candida species or Aspergillus species. This condition often occurs as a result of disseminated fungal infections from other parts of the body, commonly in individuals with weakened immune systems or those with preexisting heart valve defects or prosthetic heart valves.
Symptoms
The symptoms of fungal endocarditis can vary widely and may include:
- Fever
- Chills
- Fatigue
- Weight loss
- Muscle and joint pain
- Night sweats
- Shortness of breath
- Chest pain
- Persistent cough
- Palpitations
- Changes in heart murmur
Diagnosis
Diagnosing fungal endocarditis typically involves a combination of medical history evaluation, physical examination, blood tests, and imaging studies. Blood cultures are often conducted to identify the presence of fungi in the bloodstream. Echocardiography, including transesophageal echocardiogram (TEE), is crucial for visualizing heart valve abnormalities and detecting fungal vegetations or masses.
Treatment
The treatment approach for fungal endocarditis typically involves the administration of antifungal medications, such as amphotericin B, followed by long-term use of oral antifungal agents, such as fluconazole or voriconazole. In severe cases, surgical intervention may be necessary to repair or replace damaged heart valves.
Prognosis
Fungal endocarditis is associated with high morbidity and mortality rates. Prompt diagnosis and initiation of appropriate antifungal therapy are crucial for improving outcomes. However, even with aggressive treatment, the prognosis remains generally poor, especially in individuals with underlying conditions compromising their immune system or extensive cardiac involvement.
Prevention
Preventing fungal endocarditis involves addressing known risk factors, such as promptly treating fungal infections at other sites, managing immunocompromised conditions diligently, and utilizing prophylactic antifungal therapy during high-risk medical procedures, including surgeries involving the heart or placement of prosthetic valves. Close monitoring and proactive management of individuals with preexisting heart valve defects are also important to minimize the risk of fungal endocarditis.