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Candida tropicalis endocarditis: Treatment in a resource-poor setting


1 Department of Pediatrics, Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, India
2 Department of Pathology (Cardiovascular and Thoracic Division), Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, India

Correspondence Address:
Milind S Tullu
"Sankalp Siddhi", Block No.1, Ground Floor, Kher Nagar, Service Road, Bandra (East), Mumbai - 400 051, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2069.74051

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Year : 2010  |  Volume : 3  |  Issue : 2  |  Page : 174-177

 

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Fungal endocarditis (FE) is rare in children and does not usually occur in structurally normal hearts. The commonest causative agent is Candida albicans. We report a 5-year-old female child presenting with high-grade fever and cardiac failure. Anemia, leukocytosis and high CRP were found, but bacterial blood culture was sterile. There was no response to antimicrobial agents. Two-dimensional echocardiography revealed a large heterogeneous mass attached to the right ventricle and tricuspid valve. Provisional diagnosis of FE was made, which was confirmed by growth of Candida tropicalis in blood culture. Liposomal amphotericin B was started, followed by radical curative surgery including excision of the entire vegetation with total tricuspid valve excision. Histopathology and culture of the resected vegetation confirmed the diagnosis. The patient was given antifungal therapy for a total of 7 weeks, including 2 weeks of post-operative treatment, following which she was afebrile.






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1 Department of Pediatrics, Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, India
2 Department of Pathology (Cardiovascular and Thoracic Division), Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, India

Correspondence Address:
Milind S Tullu
"Sankalp Siddhi", Block No.1, Ground Floor, Kher Nagar, Service Road, Bandra (East), Mumbai - 400 051, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2069.74051

Rights and Permissions

Fungal endocarditis (FE) is rare in children and does not usually occur in structurally normal hearts. The commonest causative agent is Candida albicans. We report a 5-year-old female child presenting with high-grade fever and cardiac failure. Anemia, leukocytosis and high CRP were found, but bacterial blood culture was sterile. There was no response to antimicrobial agents. Two-dimensional echocardiography revealed a large heterogeneous mass attached to the right ventricle and tricuspid valve. Provisional diagnosis of FE was made, which was confirmed by growth of Candida tropicalis in blood culture. Liposomal amphotericin B was started, followed by radical curative surgery including excision of the entire vegetation with total tricuspid valve excision. Histopathology and culture of the resected vegetation confirmed the diagnosis. The patient was given antifungal therapy for a total of 7 weeks, including 2 weeks of post-operative treatment, following which she was afebrile.






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