Jamil Y, Akinleye A, Mirzaei M, Lempel M, Farhat K, Pan S. Candida endocarditis: Update on management considerations. World J Cardiol 2023; 15(10): 469-478 [PMID: 37900901 DOI: 10.4330/wjc.v15.i10.469]
Corresponding Author of This Article
Yasser Jamil, MD, Staff Physician, Department of Internal Medicine, Yale School of Medicine, No. 64 Robbins Street, Waterbury, CT 06708, United States. yasser.jamil@yale.edu
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Oct 26, 2023; 15(10): 469-478 Published online Oct 26, 2023. doi: 10.4330/wjc.v15.i10.469
Candida endocarditis: Update on management considerations
Yasser Jamil, Akintayo Akinleye, Mojtaba Mirzaei, Matthew Lempel, Kassem Farhat, Samuel Pan
Yasser Jamil, Akintayo Akinleye, Mojtaba Mirzaei, Kassem Farhat, Department of Internal Medicine, Yale School of Medicine, Waterbury, CT 06708, United States
Matthew Lempel, Department of Rheumatology, Yale School of Medicine, New Haven, CT 06510, United States
Samuel Pan, Department of Infectious Disease, Yale School of Medicine, Waterbury, CT 06708, United States
Author contributions: Jamil Y, Lempel M, and Akinleye A wrote the manuscript and contributed to the manuscript review; Jamil Y and Pan S supervised the entire project; All authors have made contributions to the conception and design of this review, engaged in preparing the article or revising it for essential intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Conflict-of-interest statement: There are no conflict of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yasser Jamil, MD, Staff Physician, Department of Internal Medicine, Yale School of Medicine, No. 64 Robbins Street, Waterbury, CT 06708, United States. yasser.jamil@yale.edu
Received: April 17, 2023 Peer-review started: April 17, 2023 First decision: July 18, 2023 Revised: August 23, 2023 Accepted: September 6, 2023 Article in press: September 6, 2023 Published online: October 26, 2023 Processing time: 190 Days and 3.3 Hours
Abstract
The rise in incidence rates of invasive candidiasis warrants an increase in attention and efforts toward preventing and treating this virulent infection. Cardiac involvement is one of the most feared sequelae and has a poor prognosis. Despite the introduction of several novel antifungal agents over the past quarter century, complications and mortality rates due to Candida endocarditis have remained high. Although fungal endocarditis has a mechanism similar to bacterial endocarditis, no specific diagnostic criteria or algorithm exists to help guide its management. Furthermore, recent data has questioned the current guidelines recommending a combined approach of antifungal agents with surgical valve or indwelling prostheses removal. With the emergence of multidrug-resistant Candida auris, a focus on improved prophylactic measures and management strategies is necessary.
Core Tip: The incidence of Candida infective endocarditis has observed a noticeable rise. Despite the progress in medical understanding, Candida endocarditis (CE) continues to be linked with a notable increase in in-hospital mortality. This comprehensive review aims to elucidate the existing diagnostic modalities for identifying CE while emphasizing their inherent limitations. Furthermore, we clarify the prevailing standard treatment protocols, encompassing medical and surgical interventions. Additionally, we highlight the role of screening techniques in identifying high-risk patients and explore the discussion of prophylactic measures tailored to specific patient phenotypes.
